Summary
Limited, poor evidence is available for comparing the treatment of extraarticular
proximal tibial fractures by intramedullary nail or plate fixation. There was no difference
in the rates of nonunion for either treatment. Significantly less patients treated
by intramedullary nailing experience infection than patients treated by plating, whereas
more patients treated by intramedullary nailing experienced malunion or compartment
syndrome than those treated by intramedullary nailing. Implant failure occurred only
in patients treated by intramedullary nailing. However, definitive conclusions cannot
be drawn from this collection of case-series and a well-conducted prospective or randomized
controlled trial would be a significant addition to this subject.
