A Comparison Of Results Between Minimally Invasive Percutaneous Plate And Interlocking Intramedullary Nail Treatment Of Tibia Shaft Fracture

Objective: To compare the clinical effects of minimally invasive percutaneousplate(MIPPO)and interlocking intramedullary nail(IIN) for treatment of tibia shaftfracture. To provide evidence to choose the methods of the treatment of the tibia shaftfracture.Methods: From May2004to July2011, a retrospectively analysis was introducedin126patients with tibia shaft fractures of the second affiliated hospital of DalianMedical University,90males and36females, the youngest is19and the oldest is67,41on average. Traffic accident in90cases,24cases are fall from the height, tamp injuryin12cases. Classified by AO.63cases was42A.27cases was42B.36cases was42C.126cases with tibia shaft fractures were divided into two groups，the age, sex,fracture types and cause of injury in both groups were basically matched and balanced.(P>0.05).Among them,67cases were treated with interlocking intramedullarynails(IIN group),and59cases were treated with minimally invasive percutaneous plateinternal fixation(MIPPO group).Patients were all followed up for6months to22months after operation(12months on average). Effectiveness, operation time,intra-operative bleeding, length of stay, healing time, activity of the knee-joint and theankle and complications were analyzed and compared retrospectively. Johnner—Wruhswas used to determine the recovery as soon as consulting the standard of healing timeand radiological diagnosis.Results: All patients were followed up for6months to22months after operation,the average followed up period was about12months. Of67cases of interlockingintramedullary nails(IIN group), the average duration of operations is86.0±13.2min, Of59cases of minimally invasive percutaneous plate internal fixation(MIPPO group), theaverage duration of operations is65.0±10.4min; The mentioned difference have statistical sense (P<0.01). The average healing time of interlocking intramedullarynails(IIN group)is3.7±0.8months and the minimally invasive percutaneous plateinternal fixation(MIPPO group) is3.6±0.7months. The mentioned difference have nostatistical sense (P>0.05). According to Johnner—Wruhs, IIN group was performed in67cases, excellent in57cases, good in8and poor in2, MIPPO group was performedin59cases, excellent in51cases, good in5and poor in3. The mentioned differencehave no statistical sense (P>0.05). The intra-operative bleeding, length of stay, healingtime have no statistical sense (P>0.05) in the two groups.Conclusions: According to a retrospectively analysis between minimally invasivepercutaneous plate and inter locking intramedullary nail for treatment of tibia shaftfracture. We know that there are no difference in intra-operative bleeding, length of stay,healing time between the two groups. The average duration of operations in MIPPOgroup is longer than IIN group but there is no knee-joint hurt in MIPPO group. Bothfollow the Bio-logical osteosynthesis principle in the operation. Both of the two groupshave very good clinical effects in the operation.