Title

Functional and radiological outcomes of distal tibia fractures treated by intramedullary nailing versus plate fixation: Comparative prospective observational study

Authors

Rishi Kaushal^1,*, Gaurav Akhand² & Adarsh Kumar Singh¹

Affiliation

¹Department of Orthopedics, Government Medical College, Sheopur, Madhya Pradesh, India; ²Department of Orthopedics, Sunderlal Patwa Government Medical College, Mandsaur, Madhya Pradesh, India; *Corresponding author

Email

Rishi Kaushal - E-mail: rishisoni34@gmail.com; Phone: +91 8770895506
Gaurav Akhand - E-mail: gakhand@yahoo.com; Phone: +91 9893129582
Adarsh Kumar Singh - E-mail: muteadarsh@gmail.com; Phone: +91 9039349838

Article Type

Research Article

Date

Received August 1, 2026; Revised August 31, 2026; Accepted August 31, 2026, Published August 31, 2026

Abstract

Extra-articular distal tibia fractures remain controversial in terms of optimal surgical fixation, with intramedullary nailing (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) offering distinct trade-offs in functional recovery and complication profiles. Therefore, it is of interest to compare the 30 Gustilo-Anderson Type I AO Type A distal tibia fractures treated with IMN or MIPPO, evaluating surgical time, blood loss, weight-bearing, union, complications and 6-month AOFAS outcomes. AOFAS scores were comparable between IMN (92.0 ± 4.97) and MIPPO (90.2 ± 4.41; p = 0.303), while IMN had shorter operative time (46.0 versus 78.33 min; p < 0.001) and faster union (4.80 vs 6.07 months; p = 0.014). MIPPO caused less blood loss (85.67 versus 245.33 ml; p < 0.001) and fewer knee symptoms, whereas plating showed more wound complications and IMN more anterior knee pain. Thus, data shows that both techniques yield similar functional outcomes, with implant choice best guided by fracture pattern, soft-tissue status and patient-specific factors.

Keywords

Distal tibia fracture, intramedullary nailing (IMN), plate fixation, minimally invasive percutaneous plate osteosynthesis (MIPPO), AOFAS score, functional outcome, fracture union

Citation

Kaushal et al. Bioinformation 22(8): 4848-4852 (2026)

Edited by

Vini Mehta

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.