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Comparision of Distal Uniplanar Locking with Biplanar Distal Locking in Intramedullary Interlocking Nailing of Fractures Distal Shaft of Tibia


Article Information

Title: Comparision of Distal Uniplanar Locking with Biplanar Distal Locking in Intramedullary Interlocking Nailing of Fractures Distal Shaft of Tibia

Authors: Rana Shahbaz Ahmad, Muhammad Suhail Amin, Muhammad Omar Rathore, Bushra Hassan, Javaid Iqbal, Adeel Qamar

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History
Category From To
Y 2024-10-01 2025-12-31
Y 2023-07-01 2024-09-30
Y 2021-07-01 2022-06-30
Y 2020-07-01 2021-06-30
Y 1900-01-01 2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 2

Language: English

DOI: 10.51253/pafmj.v72i2.5832

Keywords: Distal shaft of tibia fracturesDistal interlocking screwsIntramedullary interlocking nailingUnion time

Categories

Abstract

Objective: To study the effects of distal uniplanar locking and distal bi planar locking on union times in uncomplicated fractures distal shaft of tibia managed with an intramedullary interlocking nail.
Study Design: Comparative prospective study.
Place and Duration of Study: Department of Orthopedics and Trauma Combined Military Hospital Rawalpindi from Jan to Nov 2020.
Methodology: Fifty-three patients having fractures distal shaft of tibia managed with intramedullary interlocking nail were studied. Twenty-nine patients were managed using two interlocking screws distally (uniplanar) in coronal plane (group-1). Twenty-four patients were managed with three bi planar screws comprising two coronal and one sagittal distal interlocking screw (group-2). Patients were followed every 4 weeks, and bone union time was assessed. Isolated closed fractures treated with closed reduction were included.
Results: Patients treated with distal bi planar locking (group-2) had significantly reduced union time in weeks (11.25 ± 1.42) compared to uniplanar distal interlocking (group-1) (15.79 ± 1.80) (p<.001).
Conclusion: Union time for distal tibia shaft fractures is significantly reduced when treated with distal biplanar locking; it can be attributed to increased stability of the construct.


Research Objective

To study the effects of distal uniplanar locking and distal biplanar locking on union times in uncomplicated fractures of the distal shaft of the tibia managed with an intramedullary interlocking nail.


Methodology

A comparative prospective study involving 53 patients with fractures of the distal shaft of the tibia managed with intramedullary interlocking nails. Twenty-nine patients (group-1) were managed with two distal interlocking screws (uniplanar) in the coronal plane, and twenty-four patients (group-2) were managed with three biplanar screws (two coronal, one sagittal). Patients were followed every 4 weeks, and bone union time was assessed clinically and radiographically.

Methodology Flowchart
                        graph TD;
    A["Patient Recruitment n=53"] --> B["Fracture Type: Distal Shaft of Tibia"];
    B --> C["Intramedullary Interlocking Nailing"];
    C --> D["Group 1: Uniplanar Distal Locking"2 screws""];
    C --> E["Group 2: Biplanar Distal Locking"3 screws""];
    D --> F["Follow-up every 4 weeks"];
    E --> F;
    F --> G["Assess Bone Union Time"];
    G --> H["Statistical Analysis"];
    H --> I["Compare Union Times Between Groups"];
    I --> J["Conclusion"];                    

Discussion

Distal biplanar locking with three screws provides greater biomechanical stability than uniplanar locking with two screws, leading to a shorter union time for distal tibia shaft fractures. This enhanced stability is attributed to the increased number and multiplanar configuration of the locking screws.


Key Findings

Patients treated with distal biplanar locking (group-2) had a significantly reduced union time (11.25 ± 1.42 weeks) compared to those treated with uniplanar distal interlocking (group-1) (15.79 ± 1.80 weeks) (p<.001).


Conclusion

Union time for distal tibia shaft fractures is significantly reduced when treated with distal biplanar locking, which can be attributed to the increased stability of the construct.


Fact Check

- The study included 53 patients.
- The mean union time for the biplanar locking group was 11.25 ± 1.42 weeks.
- The mean union time for the uniplanar locking group was 15.79 ± 1.80 weeks.


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