Closed Intramedullary Nailing Vs. Percutaneous Plating for Distal Tibia Metaphyseal Fractures

Abstract

Background: Distal tibial metaphyseal fractures are difficult orthopedic injuries due to the fact that they are relatively soft tissue-deficient and hard to fix without compromising the fracture biology.

Objective: The clinical, radiological, and functional results of closed intramedullary nailing versus percutaneous plating of distal tibial metaphyseal fracture.

Materials and Methods: The study was a prospective comparative study at the Khyber Teaching Hospital Peshawar from September 2025 to February 2026. A total of 80 patients with extra-articular distal tibial metaphyseal fractures were randomly divided into two groups: intramedullary nailing and percutaneous plating.

Results: The intramedullary nailing group had a significantly lower blood loss, shorter hospital stay, and lower operative time. There was no difference in the rate of fracture union or functional results, but plating had slightly better alignment and more superficial wound complications and implant irritation.

Conclusion: Both methods are effective, but intramedullary nailing is more efficient in the operation and has a quicker recovery.