Analysis of Proximal Plating Versus Intramedullary Nailing in the Treatment of Extra-articular Proximal Tibial Fracture: A Randomized Prospective Study.

Background: Extra-articular fractures of the proximal tibia are extremely difficult to treat. These fractures can be treated with intramedullary nailing (IMN), closed reduction, and minimally invasive plating. Objective: The objective of this study was to compare the efficacy of proximal plating versus IMN in the treatment of extra-articular proximal tibial fractures. Materials and Methods: The present randomized prospective clinical study was carried out at the department of orthopedics, Isra University Hospital, Hyderabad, from May 2024 to December 2024 on 62 individuals with fracture of the proximal tibia who underwent proximal tibial plating (PTP) or IMN after taking permission from the ethical board of the institute. Computer-assisted prospective randomization was used to assign participants to groups. Participants in Group A received IMN treatment, whereas those in Group B received PTP. Data were analyzed through the Statistical Package for the Social Sciences version 24. The significance threshold that was used was P < 0.05. Age, sex, hospitalization, infection rate, fracture union duration, and fracture angulation were all compared between the two groups. The interval data (age, operative time, fracture union time, and knee movement) were subjected to a paired-sample t-test. Results: A total of 48 cases were studied, which were divided into two groups. Significantly shorter stay at hospital after surgery (value of P = 0.035), time for union, and time to full bearing of weight (P = 0.004) were experienced by the IMN group as compared to Group B. However, neither technique clearly outperformed the other groups with regard to operative time (P = 0.082), rate of infection (P = 0.738), knee range of motion (P = 0.462), or degrees of malunion or non-union. Conclusion: The current study concluded that there was no noteworthy difference between the two techniques in relation to surgical duration, rate of infection, and frequency of malunion and non-union. However, IMN is better than minimally invasive plating in terms of the duration of hospital stay, speed of union, and early full weight bearing.