In This SectionTexas Health Research & Education Institute
Disease or Condition
Orthopedics / Fracture Repair
Inter-locking nail or Nails versus Plate attachement (Orthopedics / Fracture Repair)
This study looks at two (2) types of surgical treatments to hold the bones while healing. This study is being done to determine if one procedure is better that the other.
Extraarticular fracture of the proximal tibia extending into the metaphyseal with or
without intraarticular extension not requiring open reduction with complete AP and
Major fracture line not closer than 4cm from the proximal tibial articular surface.
Fracture requiring operative treatment amenable to either IM nail or plate.
Surgeon agreed to randomize patient.
Informed consent obtained.
Patient is English speaking.
Patients may have undergone previous surgical interventions either for placement of a spanning external fixator and/or debridement of open fracture wounds. This may have been done at the eventual treating institution or not. That is, the patient could represent a referral of a proximal tibia fracture, which had undergone previous debridement and / or spanning external fixator placement elsewhere.
Tibial shaft fracture not amenable to intramedullary nailing (i.e. fracture is less than 4 cm from joint surface).
Fracture of the proximal tibia with intraarticular extension requiring open reduction.
Known metabolic bone disease.
Separate displaced tibial tubercle fragment.
Soft tissue injuries compromising treatment method with nail, plate, or both.
Fractures with vascular injury (Gustillo Type IIIC injury) requiring repair.
Compartment syndrome of the leg diagnosed preoperatively 8. Pathological fracture.
Retained hardware or existing deformity in the affected limb that would complicate IM nailing, plating, or both.
Symptomatic knee arthritis.
Surgical delay greater than 3 weeks for closed fractures or 24 hours for open fractures.
Contralateral proximal tibia fractures (bilateral injury) or ipsilateral lower extremity injury that would compromise function of the knee.
Unable to comply with postoperative rehabilitation protocols or instructions (i.e. head injured or mentally impaired).