radiological parameters, time to union and complications requiring additional treatment. Paired Students t-Test was used to compare radiographic parameters from before and after corrective osteot- omy. Independent Student′s t-Test was used to compare range of motion and grip strength of the injured and uninjured side and to compare VAS pain scores from before and after corrective osteotomy. Results: A total of 52 patients were included in this study. The mean agewas 53.3 years (SD 15.4) and 71% was female. The mean time to follow up was 39 months (range five to 169 months). Forty-six patients underwent a distal radius open wedge osteotomy and shortening of the ulna was performed in six patients. Out of the 44 patients that completed the DASH questionnaire, the median score was 10.0 (IQR 5.6 to 18.9). Out of the 43 patients that completed the PRWE questionnaire, the median score was 13.5 (IQR 4.5 to 27.0). All radiographic parameters improved significantly compared to the pre-operative status (p < 0.01). The median time to union was 24 weeks (range four to 128). Dorsal and palmar flexion of the wrist and ulnar deviation showed a significant difference compared to the uninjured wrist. VAS scores decreased significantly from 5.8 preoperative to 1.5 postoperative (p < 0.01). Complications occurred in 54% of the patients. Re-corrective osteotomies had to be performed in 7 patients, two due to non-union and ulnar abutment and 5 due to hardware failure. Conclusions: Corrective osteotomy is an effective method of treating distal radius malunion with good long-term functional results. Both DASH- and PRWE-scores were low and pain scores decreased after the corrective osteotomy. Moreover, radiographic parameters improved significantly after the corrective osteotomy. Session V: Nail vs. plate vs. prosthesis: distal lower leg, pilon and ankle fractures OS5-33 Surgical treatment of distal tibia fractures with intra-medullary nail D. Vermesan 1 , C. Faur 1 , B. Anglitoiu 1 , M. Oprea 1 , D.V. Poenaru 1 . 1 2nd Clinic of Orthopaedics and Traumatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Introduction: Fractures of the distal tibia in the adult result from a combination of axial compression and rotational forces. Surgical treatment of extra-articular fractures of distal tibia is a controversial topic throughout the entire literature. The recent development of more distal locking options with IM nails and anatomically-contoured angle-stable plates have improved our ability to stabilise these fractures. Material and Methods: This study included 27 patients admitted and treated for distal extra-articular tibial fractures (AO 43 A1-3) between Jan 2012 and May 2015 in the 2nd Clinic of Orthopaedics and Traumatology. Ten patients sustained open fractures (two type I GA, four type II GA and four type IIIA GA). Nine patients also had distal peroneal or peroneal malleolus associated fractures and 18 had associated supra-malleolar fractures of the peroneus. IM nailing was the treatment choice for all cases (with reaming in 14 cases) and for the associated peroneal fractures ORIF with plates and screws was performed. Results: From a total of 27 cases, 4 (14.8%) cases healed with a varum >5° deformity, 3 (11.1%) cases developed pseudarthrosis that necessitated further surgical treatment (angular stable plates and bone graft), 1 (3.7%) case had intraarticular nail migration and infection, 19 (70.4%) cases had a favourable evolution with good outcome. All fracture healing complications appeared within the cases treated without medullary canal reaming and without associated distal peroneal fractures. Conclusions: Cases treated with ORIF for distal peroneal fractures had better results that those treated by conservative means. IM nailing can be extremely important in open fractures where it can provide excellent fixation of the fracture fragments and allows, if necessary, extensive debridement and reconstructive treatment for soft tissues without direct implant exposure. It was also noted that reamed nailing was biomechanically superior in terms of stability to the unreamed nails. OS5-34 Comparison of plate versus intra-medullary nail fixation for distal tibia fractures without articular involvement M.C. Sozbilen 1 , G. Hatami 1 , K. Kayaokay 1 , O. Suer 1 , N. Ozkayin 1 , K. Aktuglu 1 . 1 Orthopedics, Ege University, Izmir, Turkey Aim: The objective of this study was to evaluate distal tibia shaft fractures treated with plate or nail in terms of radiographic & clinical results and complication rates. Methods: 109 patients with distal tibia shaft fractures (3 and 11cm proximal to the ankle joint) were reviewed retrospectively between July 2008 and December 2015. The fracture pattern, AO classification, open fracture, complications and union were evaluated after a mean of 24 months (12–65 months range). Patients were divided into three groups according to the location of fractures (proximal, middle and distal). Statistical analysis was performed utilizing SPSS v21. Results: 47 women and 62 men with a mean age of 39.41 years (18 to 71) were evaluated. 43 fractures were treated with an intramedullary nail and 66 fractures were treated with a plate. 58 patients (53.2%), 35 patients (32.1%) and 16 patients (14.7%) were classified according to AO classification as 42-a, 42-b and 42-c, respectively. 23.8% of the patients had open fractures. Osteomyelitis developed in four patients (3.9%): three of the patients after plating and one of the patients after intramedullary nailing. Only one patient from each group had nonunion. However, 15 patients (13.8%) had delayed union, ten patients (9.1%) developed delayed union after nailing versus five (4.5%) plating (p. Seven of all delayed unions (46.6%) were in proximal part (p ≥ 0.05). The absence of concomitant fibula fracture is not related to delayed union (p. Angular malalignment of ≥3 degrees occurred in nine patients with nails (8.2%) and 14 patients with plate (12%) (p ≥ 0.05). Valgus was the common deformity (n = 12). Conclusions: High union rates were determined after surgical treatment of distal tibia shaft fractures with both plates and intramedullary nails. Delayed unions were more frequent after nailing however malunion was not significantly different between nailing versus plating. Location of fracture does not affect the union or malunion rates. OS5-35 Biomechanical analysis of three fixation methods in treatment of pilon fractures AO 43-C3 B. Puha 1 , T.S. Gheorghevici 1 , E. Carata 2 , W. Friedl 3 , S. Rares 4 , P.-D. Sîrbu 1,4 . 1 Orthopedics, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania, 2 Department of Machine Tools, “Gheorghe Asachi” Technical University, Iasi, Romania; 3 Orthopädie, Unfall- und Handchirurgie, Klinikum Aschaffenburg-Alzenau, Chirurgische Klinik II, Aschaffenburg, Germany; 4 Orthopedics and Traumatology Clinic, Emergency Universitary Hospital “Sf. Spiridon”, Iasi, Iasi, Romania Introduction: The treatment of pilon fractures is still in debate due to high number of complications and the variety of methods of treatment. Objectives: to investigate the efficacy of three methods of osteo- synthesis of AO 43-C3 pilon fractures, by biomechanical testing: medial locked plate (G1), antero-lateral locked plate (G2) and 2 Xs- nail and screws (G3). Osteosynthese International 2016 /Injury, Int. J. Care Injured 47S5 (2016) S1–S38 S13