الفهرس 
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Abstract
Fractures involving the extra-articular distal third tibia is one of the most common problems facing orthopedic surgeons .This fracture is treated either conservatively by casting in selected cases or surgically by plate, external fixator or intramedullary nailing.
This study included twenty five patients admitted to El-Hadara University Hospital suffering from closed distal tibial shaft fractures between November 2015 till January 2017, They were divided into two groups, groupI (14 patients) with plating fixation technique and group II (11 patients) with intra-medullary fixation technique.
The aim of this work was to assess the clinical and radiological results and complications for patients having distal extra-articular tibial fractures treated by plating or intra-medullary nailing.
On follow up after collection initial database from medical registration, all patients were assessed by history taking, clinical examination, and radiological assessment.
In group I, the youngest patient was twenty three years old and the oldest was sixty five years old with a mean of 38.5 years. There were ten males and four females. Eight patients (57.1%) with right side involvement and six patients (42.9%) with left side fractures, twelve patients (85.7%) had simple A2-A3 fractures and two patients (14.3%) with undisplaced articular fractures B1 fractures. eight patients (57.1%) were due to road traffic accidence (RTA), six patients (42.9%) due to other causes like Assault or FD trauma.
In group II, the youngest patient was twenty five years old and the oldest was forty nine years old with a mean of 33.0 years. There were six males and five females. Six patients (54.5%) with right side involvement and five patients (45.5%) with left side fractures, eight patients (72.8%) had simple A1-A3 fractures, three patients (18.2%) with wedge B1 fractures. Nine patients (81.8%) were due to RTA, and two patients (18.2%) due to FFH.
The patients were followed up at three months postoperatively to compare between the two techniques according to clinical and radiological parameters.
The final results according to the Olerud-Molander scoring system were that five patients (35.7%) had Fair result, six patients (42.9%) had Good result and three patients (21.4%) had Excellent result in group I, while four patients (36.4%) had Fair result, three patients (27.3%) had Good result and four patients (36.4%) had Excellent result in group II, and also according to modified system of Ekeland et al were that eight patients(57.1%) of group I had satisfactory results and six patients (42.9%) had unsatisfactory results. In group II seven patients (63.6%) had satisfactory and four patients (36.4%) had unsatisfactory results.
In group I, five patients (35.7%) had delayed or no bony union at time of evaluation .In group II, four patients (36.4%) had delayed or no bony union at time of evaluation