Clinical application of intramedullary nail fixation assisted by locking plates in segmental tibia fractures: A retrospective study

It is unclear whether small plates are needed for augment fixation to provide a more stable mechanical environment in segmental fractures of the tibia treated with intramedullary nail. The purpose of this study was to investigate the efficacy of intramedullary nailing combined with locking plates in the treatment of segmental fractures of the tibia. This study included 41 patients with segmental tibia fractures between January 1, 2018 and January 1, 2023. Eighteen patients were treated with an intramedullary nail assisted by a locking plate (combination group), and 23 patients were treated with an intramedullary nail without a plate (nail group). The perioperative parameters of all patients were recorded, and clinical efficacy was evaluated during follow-up. The operation time was shorter but the incision was longer in the combination group (P < .05). The numbers of fluoroscopy procedures and the time to union were shorter in the combination group (P < .05). The rate of malunion in the nail group (4, 17.4%) was significantly greater than that in the combination group (0, 0%). At the last follow-up, no statistically significant differences in walking ability were detected. Our results suggest that a locking plate combined with an intramedullary nail for segmental tibial fractures may require a longer surgical incision, but it has significant advantages such as a shorter operative time and time to union, a shorter fluoroscopy time, and a lower rate of malunion and nonunion. Intramedullary nail fixation assisted by a locking plate is an effective method for treating segmental fractures of the tibia.