Özet:

Objective: Our aim was to investigate the results of intramedullary nailing in tibial diaphyseal fractures extending to the distal tibial joint line and to compare them with the minimally invasive plate osteosynthesis method. Materials and Methods: All patients who were treated and followed-up in our clinic between 2019 and 2021 for tibial diaphyseal fracture extending to the tibial distal joint line but without impact on the joint were retrospectively investigated. Demographic data such as age, gender and side, injury mechanisms, tibia diaphysis and pilon fracture types, clinical pain scores, radiological union rates and complications of all patients were evaluated. Results: Of the 27 patients included in the study, 15 patients (55.56%) were treated with intramedullary nailing, while minimally invasive plate osteosynthesis was used in 12 patients (44.44%). While the median age of the IMN group was 62 years (Range: 34-67 years), the median age of the MIPO group was 51 years (Range: 33-52), and there was a significant difference between them (p=0.038). There was a significant difference between the groups in terms of injury mechanisms (p=0.023). There was no difference between the two groups in terms of side, gender, fracture type and pain scores (p>0.050). Radiological complete recovery was achieved in all patients. Soft tissue-related complications were detected at the wound site in four patients (14.81%). It was observed that all the patients who developed complications were in the MIPO group, and a significant difference was found between the groups in terms of complication rates (p=0.028). Conclusion: In tibial diaphyseal fractures extending to the distal tibial joint line, if the joint is not accompanied by impaction, satisfactory clinical and radiological results and low complication rates can be obtained with intramedullary nailing, which is applied after obtaining absolute stability in the joint with percutaneous cannulated screws.

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