Open distal tibial shaft XXXX : a retrospective comparison of medial plate versus nail fixation.

@entity1 @entity1538 @entity174 @entity5806 @entity260 @entity281 @entity158 @entity130
PURPOSE: Studies comparing @entity1538 ( @entity1538 ) vs. @entity5806 ( @entity5806 ) for distal tibia shaft @entity174 focus upon closed injuries containing small @entity1 series with open @entity174 . As such, complication rates for open @entity174 are unknown. To characterize complications associated with @entity1538 vs. @entity5806 , we compared complications based on surgical approach in a large @entity1 series of open distal tibia shaft @entity174 . METHODS: Through retrospective analysis at an urban level I @entity130 center, 180 @entity5806 and 36 @entity1538 @entity1 with open distal tibia @entity174 from 2002 to 2012 were evaluated. @entity1 charts were reviewed to identify @entity1 demographics, @entity174 grade (G), @entity1 comorbidities, and postoperative complications including nonunion, malunion, @entity281 , hardware-related @entity158 , and wound dehiscence. Fisher's exact tests compared complications between @entity1538 and @entity5806 groups. Multivariate regression identified risk factors with statistical significance for the development of a @entity260 . RESULTS: One hundred and eighty @entity5806 (G1 22, G2 79, and G3 79) and 36 @entity1538 (G1 10, G2 16, and G3 10) @entity1 were included for analysis. @entity1538 @entity1 had a higher rate of nonunion (25.0  %, n  =  9) compared with @entity5806 @entity1 (10.6  %, n  =  20, p  =  0.03). No additional complication had a significant statistical difference between groups. Multivariable analysis shows only surgical method influenced the development of complications: @entity1538 @entity1 had 2.52 greater odds of developing complications compared with @entity5806 @entity1 (95  % CI 1.05-6.02; p  =  0.04). CONCLUSIONS: @entity1538 leads to higher rates of nonunion and significantly increases the odds of developing a complication compared with @entity5806 for open distal tibia @entity174 . This is the first study investigating complication rates based on surgical approach in a large cohort of @entity1 with exclusively open distal tibia @entity174 .
