Clinical Comparison Of Minimal Invasive Percutaneous Plate Osteosynthesis With Interlocking Intramedullary Nail Intreatment Of The Middle And Lower Segment Tibia Fractures

Objective:Study of minimally invasive percutaneous plate and interlocking intramedullary nail these two kinds of operation method in the treatment of the middle and lower segment tibia fractures of the curative effect of close fracture, Comparing the resutls, so as to provide the reference for the clinical treatment, in order to obtain a better clinical effect.Methods:A retrospective study of 75 patients with distal tibial fractures in our hospital were admitted to department of orthopedics patients from February 2012 to February2014,with using minimally invasive percutaneous plate fixation and interlocking intramedullary nail fixation,two groups of patients were 37 cases and 38 cases,and the follow-up time was more than 12 months.Statistical two groups pre-operative hospitalization time, operation time,intraoperative blood loss, intraoperative fluoroscopy times, operative incision, postoperative complications(postoperative infection, fracture delayed union or nonunion, loosening of internal fixation fracture, lower limb deep vein thrombosis, pain of knee joint or ankle, varus and valgus of ankle), clinical healing time of fracture.During the follow-up process Johner & wruhs curative effect evaluation standard was used to assess limb function,the fracture clinical healing time in patients with limb can be completely weight, X ray film is based on the fuzzy or fracture.Assessment with minimally invasive percutaneous plate and interlocking intramedullary nail in the treatment of clinical effect of the middle and lower segment tibia fractures.Results:Compared with Minimally invasive percutaneous plate group and intramedullary nail group: pre-operative hospitalization time were(7.38±2.38) and(5.39±2.78)min, the difference of two groups was statistically significant(P<0.05), the latter was better than the former; the operation time were(71.89±13.25) and(88.82±22.61)min,There was statistically significant between the two groups(P<0.05),the former was obviously superior to the latter;intraoperative blood loss were(76.62±12.14) and(126.58±33.95)ml,there was significant difference between two groups(P<0.05),the former was obviously superior to the latter;intraoperative fluoroscopy times were(7.43±2.34) and(9.37±2.99)time,the difference was statistically significant(P<0.05),the former has more advantage than the latter;operative incision were(10.86±2.31) and(10.76±2.27)cm,there was not statistically significant between the two groups(P>0.05); the fracture healing time were(19.43±2.69) and(20.29±3.99)weeks,there was not significant difference between two groups(P>0.05).There were 1 case of postoperative infection,1 case of delayed union, no ankle pain,no loosening of internal fixation fracture, no venous thrombosis,no knee pain and no arus and valgus of ankle in minimally invasive percutaneous plate osteosynthesis group;1 cases of postoperative infection, 2 cases of delayed union, 4 cases of knee joint pain, 1 case of arus and valgus of ankle in interlocking intramedullary nail group,so there was statistical significance between the two groups in postoperative complications(P < 0.05),and the former was less than the latter in complications occur rate.The excellent rate of postoperative function score was 91.2% in minimally invasive percutaneous plate group,and the intramedullary nail group,the postoperative function score excellent rate was 86.8%,the function of two groups of postoperative score had no significantdifference(P>0.05).Conclusion:Minimally invasive percutaneous plate and interlocking intramedullary nail are effective method in the treatment of the middle and lower segment tibia fractures.Minimally invasive percutaneous plate and interlocking intramedullary nail are effective method in the treatment of tibial shaft fractures. Minimally invasive percutaneous plate osteosynthesis has shorter operative time, less intraoperative blood loss, less fluoroscopy times, less postoperative complications and other advantages,but interlocking intramedullary nail with preoperative also has less time pre-operative hospitalization, good of the curative effect,the specific choice of the surgical approach should be based on the doctor’s clinical experience and comprehensive analysis of fracture type.