Comparative Analysis of Plate-and-Screw Fixation and Intramedullary Nailing in Tibia-Fibula Fracture Management Across Asian Surgical Centers
Keywords:
tibia-fibula fracture, plate-screw fixation, intramedullary nailing, surgical outcomes, functional recovery, AsiaAbstract
Tibia-fibula fractures represent a significant orthopedic challenge in Asian populations, with mounting epidemiological pressure from road traffic accidents and workplace trauma. This study compares functional and radiological outcomes between plate-and-screw fixation (PSF) and intramedullary nailing (IMN) in 212 patients with closed diaphyseal tibia-fibula fractures across six tertiary centers in Central Asia. Patients aged 18–65 years with fractures requiring surgical intervention were included; those with open fractures (Gustilo-Anderson ≥ Grade 2) or polytrauma were excluded. PSF (n=106) and IMN (n=106) groups were evaluated at 6, 12, and 24 weeks postoperatively using radiological union scoring for tibia (RUST) and Lower Extremity Functional Scale (LEFS). Primary outcomes were time to radiological union and functional recovery; secondary outcomes were infection rates and implant-related complications. Results demonstrated earlier radiological union in the PSF group (mean 14.2±2.1 weeks vs. 16.8±2.9 weeks; p<0.001) and comparable functional outcomes at 24 weeks (LEFS: PSF 72.4±8.3 vs. IMN 70.1±9.1; p=0.156). Infection rates were significantly lower in the IMN group (2.8% vs. 8.5%; p=0.031). This analysis provides evidence-based guidance for surgical selection in resource-limited Asian healthcare settings.
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