Volume : VII, Issue : III, March - 2018

RANDOMIZED CONTROLLED TRIAL COMPARING OUTCOME OF HYBRID ILIZAROV VERSUS DISTAL TIBIAL METAPHYSEAL LOCKING PLATE FOR TREATMENT OF DISTAL TIBIAL FRACTURES IN ADULTS

Dr. Jeevan Kumar Sharma, Dr. Pashupati Chaudhary, Dr. Raju Rijal, Dr. Bishnu Pokharel

Abstract :

 

Background: Distal tibia fractures include extraarticular fractures of the metaphysis and the more severe intra–articular tibial plafond or pilon fractures. Incidence ranged from a low of 3 per 10,000 per year among 30 to 34–year–old women to a high of 28 per 10,000 per year among 15 to 19–year–old boys. More data are available for pilon fractures. These fractures are estimated to comprise 3% to 10% of all tibia fractures and less than 1% of lower extremity fractures. Several treatment methods have been recommended for the treatment of these injuries, including, varieties of external fixation, intramedullary nailing (with and without reaming), plate fixation with a recent emphasis on minimally invasive techniques and non–operative treatment also.These treatment options have their own benefits and complications. Several studies regarding distal tibial fracture treatment are available. They are mainly prospective and retrospective studies with variable results. Few of them are only randomized controlled trial. So, we conducted this research compå distal tibial plating (P) versus hyid ilizarov (HI) for treatment of distal tibial fractures.

 

Methods: The study was conducted in the Department of Orthopaedics, B.P. Koirala Institute of Health Sciences, a tertiary care hospital in Eastern Nepal, over a period of fifteen months from June 2015 to August 2016. Ethical clearance was obtained from Institutional Review Committee (IRC). Research Design was Randomized Controlled Trial. Patient in group A underwent hyid Ilizarov fixation, and group B underwent plating.

 

Results: Gender ratio for male: female was 2.63 in hyid ilizarov, 1.35 in plating group. Mean age was 47.03+/–15.93 and 42.1+/–12.788 for HI and P respectively. Most fractures in both group belonged to AO A3 type. Most surgeries were done at interval of 1 day to 1 week. Mean hospital stay was 6.43+/–4.545 and 4.93+/–4.676 for HI and plating respectively. Lower extremity functional score (LEFS) ranged from 59 to 73 with mean of 66.55 in HI and 67.15 in plating group. Percentage of maximal function (LEFS/80 *100) ranged from 73.75 to 91.25 with mean of 83.56. Three cases among 40 cases in Plating had infection but no infection in HI group was seen at the end of 12th week follow up.

 

Conclusion: Our study showed that there is no significant difference in terms of LEFS criteria, union, fracture alignment, ROM (knee, ankle), infection and other outcome measures between Hyid ilizarov fixation and plating in the treatment of distal tibia fracture in adults.

 

 

 

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Dr. JEEVAN KUMAR SHARMA, Dr. PASHUPATI CHAUDHARY, Dr. RAJU RIJAL, Dr. BISHNU POKHAREL, RANDOMIZED CONTROLLED TRIAL COMPARING OUTCOME OF HYBRID ILIZAROV VERSUS DISTAL TIBIAL METAPHYSEAL LOCKING PLATE FOR TREATMENT OF DISTAL TIBIAL FRACTURES IN ADULTS, INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-7 | Issue-3 | March-2018


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