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14 September 2023 : Clinical Research  

[In Press] Comparative Study of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary Nailing (IMN) for Treating Extraarticular Distal Tibial Fractures: Clinical and Radiological Outcomes

Oğuz Kaya ORCID logo1ABC, Hacı Bayram Tosun ORCID logo2AC, Hüseyin Kürüm ORCID logo3DE, Sancar Serbest ORCID logo4CD, Abuzer Uludağ ORCID logo5BF, Orhan Ayas ORCID logo6BCG

DOI: 10.12659/MSM.942154

Med Sci Monit In Press; DOI: 10.12659/MSM.942154  

Available online: 2023-09-14, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Treatment of extra-articular distal tibial fractures is problematic owing to limited soft tissue cover, poor vascularity of the location, and adjacency to the ankle, and thus continues to be controversial. This study aimed to compare clinical and radiological outcomes in 69 patients with extra-articular distal tibia fractures treated with minimally invasive plate osteosynthesis (MIPO) and an interlocking intramedullary nail (IMN).
Sixty-nine patients, with mean of age 39.8±18.3 years, were retrospectively evaluated. Thirty-five patients were treated with IMN, and 34 patients were treated with MIPO. Clinical and radiological outcomes were evaluated.
The average follow-up was 13.3±6 months and union time was 16.2±5.4 weeks. Nonunion was observed in only 4.3% of patients treated with MIPO (P=0.114). Non-acceptable malalignment of extremity was observed in 4.3% of patients with IMN and 7.2% of patients with MIPO. There were no significant differences in union time, nonunion, surgical timing, operating time, malalignment, and complications between groups (P>0.05). The mean American Orthopaedic Foot and Ankle Society (AOFAS) surgery score was 95.8±5 in IMN and 91.9±14.3 in MIPO. AOFAS, Tenny-Wiss radiological, and Ovadia-Beals clinical scores were better in IMN than MIPO (P=0.019, P=0.03, P=0.02, respectively). Mean time of full weight-bearing and of return to daily life with IMN was significantly shorter than with MIPO (P<0.001).
IMN and MIPO methods are reliable and effective methods with similar good results in the surgical treatment of extra-articular distal tibia fractures. However, IMN may be preferred for early full weight-bearing and early return to daily life (P<0.001).

Keywords: Fracture Fixation, Intramedullary; Minimally Invasive Surgical Procedures; Tibial Fractures; Intra-Articular Fractures; Fractures, Bone


01 September 2023 : Editorial  

Editorial: A Rapid Global Increase in COVID-19 is Due to the Emergence of the EG.5 (Eris) Subvariant of Omicron SARS-CoV-2

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.942244

Med Sci Monit 2023; 29:e942244


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750