الفهرس 
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Abstract
Distal tibial fractures represent 3% to 10% of all tibial fractures or 1% of lower extremity fractures and occur associated with a fibular fracture in 70% to 85% of cases and this occurs in more complex injuries. Distal tibia fractures are complex injuries with a high complication rate and the goal of orthopaedic surgeons is to restore the tibial anatomy, to achieve appropriate fixation and to avoid complications.
Many techniques are used for management of distal tibial fractures each with its advantages and disadvantages. These techniques include traditional open reduction and internal fixation, external fixation with or without limited internal fixation, intramedullary nailing or, more recently, minimally invasive plate osteosynthesis.
This study is a prospective randomized clinical trial that was conducted on 36 patients with distal extra-articular tibial fractures in order to compare the outcome of intramedullary nail (Expert Tibial Nail “ETN”) versus distal tibial locked plate (DTLP) fixation in the treatment of extra-articular distal tibial fractures in terms of functional and radiological outcome. Patients were randomly allocated into 2 groups: The first group was managed by distal tibial plating and the second group was managed by tibial interlock nailing (Expert Tibial Nail). This study was conducted in Suez Canal University Hospital during the period between February 2017 and August 2018.
These patients were followed up for a minimum of 6 months.
The collected data was revised, coded, processed and analyzed using SPSS program for windows version 20 and the appropriate tests of significance were conducted to compare between groups. A (P) value of < 0.05 was considered to be statistically significant, a P value of < 0.01 was considered to be highly statistically significant and a P value of < 0.001 was considered to be very highly statistically significant.
The main findings of this study were ETN was advantageous over plate with lower incidence of incidence of infection , union rate , union time, knee and ankle stiffness , incidence of mal-alignment complications , implant failure and need for second surgery and comparable operation time ,. However, it was disadvantageous in the presence of post-operative anterior knee pain