Analysis of clinical efficacy of intramedullary nail and minimally invasive percutaneous plate osteosynthesis in the treatment of middle-distal tibia fractures

doi:10.3877/cma.j.issn.2096-0263.2020.04.001

Abstract

Abstract:

Objective

To compare the clinical efficacy of intramedullary nail (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of middle-distal tibial fractures.

Methods

A retrospective study was conducted on 60 middle-distal tibia fractures treated with IMN (30 cases) and MIPPO (30 cases) in our hospital from January 2016 to December 2019, the clinical effects of the two therapeutic method was compared.

Results

All the 60 patients were followed up for 12 to 26 months. Compared to MIPPO group, the preoperative waiting time and hospitalization time were shorter in IMN group, the differences were statistically significant (P<0.05). There were no statistically significant differences in tibial operation time, intraoperative fluoroscopy times, intraoperative blood loss, fracture healing time and Johner-Wruhs score between the two groups. There were no statistical difference in the complications of anterior knee pain, soft tissue irritation, malunion, bone nonunion and delayed union. The incidence of wound complications was lower in IMN group than in MIPPO group (P<0.05).

Conclusions

Both intramedullary nail and percutaneous locking plate are effective methods for the treatment of middle-distal tibia fractures. The intramedullary nail internal fixation has little interference to the skin and soft tissue, so it is more suitable for the patients with poor local soft tissue conditions.

Key words: Tibia fractures, Fracture fixation, Intramedullary nail nail, Locking plate

Yuezhong Lang, Yong Liu. Analysis of clinical efficacy of intramedullary nail and minimally invasive percutaneous plate osteosynthesis in the treatment of middle-distal tibia fractures[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(04): 184-190.

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References 36

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组别	例数	年龄（岁，±s）	受伤类型（例）		OTA分型（例）			受伤原因（例）
组别	例数	年龄（岁，±s）	低能量损伤	高能量损伤	42-A	42-B	42-C	交通事故	摔伤	运动伤	重物砸伤
MIPPO组	30	38±6	16	14	17	10	3	12	11	4	3
IMN组	30	36±8	18	12	18	8	4	10	12	5	3
统计值		t=0.838	χ²=0.272		χ²=0.117			χ²=0.477
P值		0.400	0.602		0.468			0.725
组别	例数	随访时间（月，±s）	性别（例，男/女）	是否合并开放性骨折（例）		是否合并腓骨骨折（例）
组别	例数	随访时间（月，±s）	性别（例，男/女）	是	否	是	否
MIPPO组	30	18±3	21/9	4	26	11	19
IMN组	30	16±4	19/11	6	24	10	20
统计值		t=1.268	χ²=0.300	χ²=1.171		χ²=0.073
P值		0.209	0.584	0.488		0.787

组别	例数	年龄（岁，±s）	受伤类型（例）		OTA分型（例）			受伤原因（例）
组别	例数	年龄（岁，±s）	低能量损伤	高能量损伤	42-A	42-B	42-C	交通事故	摔伤	运动伤	重物砸伤
MIPPO组	30	38±6	16	14	17	10	3	12	11	4	3
IMN组	30	36±8	18	12	18	8	4	10	12	5	3
统计值		t=0.838	χ²=0.272		χ²=0.117			χ²=0.477
P值		0.400	0.602		0.468			0.725
组别	例数	随访时间（月，±s）	性别（例，男/女）	是否合并开放性骨折（例）		是否合并腓骨骨折（例）
组别	例数	随访时间（月，±s）	性别（例，男/女）	是	否	是	否
MIPPO组	30	18±3	21/9	4	26	11	19
IMN组	30	16±4	19/11	6	24	10	20
统计值		t=1.268	χ²=0.300	χ²=1.171		χ²=0.073
P值		0.209	0.584	0.488		0.787

组别	例数	术前等待时间（d，±s）
MIPPO组	30	10.4±3.2
IMN组	30	6.1±2.3
统计值		t=5.976
P值		<0.05

组别	例数	术前等待时间（d，±s）
MIPPO组	30	10.4±3.2
IMN组	30	6.1±2.3
统计值		t=5.976
P值		<0.05

组别	例数	Johner-Wruhs评分（例）
组别	例数	优	良	中	差	优良率（%）
MIPPO组	30	18（60.0）	9（30.0）	3（10.0）	0	90
IMN组	30	19（63.3）	9（30）	2（6.7）	0	93.3
χ²值						3.840
P值						0.640

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