The Comparison Of Two Kinds Of Minimally Invasive Surgical Treatment Of Tibial Fracture In The Middle And Distal Segment

Objective: The research is about two kinds of minimally invasive surgical treatment between interlocking intramedullary nails and percutaneous minimally i nvasive locking compression plate(MIPPO),used in the treatment of tibial fractu res in the middle and distal segment.To provide a reference for the treatment a bout the disease.Methods: 61 patients were treated in our hospital from May 2013 to June 2015 with minimally invasive ways of the middle and distal segment closed tib ial fracture in our department.According to the surgical options the patients are divided into two groups: interlocking intramedullary nails(group A)and MIPP O(group B).Using appropriate statistical methods about the gender,fracture of AO type,age of the two groups;Related to postoperative complications;Lowe r limbs is analyzed by the forward rate of good function of postoperative with the Johnner-Wruhs score.Results: Using SPSS19.0 statistical software analysis the data.P<0.05 mean s statistical significant,P<0.01 has significant meaning.The operation time of g roup A and group B severally is 80.6±6.5 min and 60.9 ±5.8 min.Intraoperati ve blood loss respectively is 112.7 ± 7.8ml and 91.3 ± 13.7 ml.Using t test to compare the data between the two groups,show that there has a difference(P<0.05).The operation time and blood loss in group A is higher than that in group B.The average fracture healing time between group A and group B seve rally is 14.3±1.7weeks and 14.1±1.5 weeks.There is no statistically significantdifference(P=0.519>0.05),shows that the clinical healing time of fracture in b oth groups has no obvious difference.Both group A and group B are occurred to fracture delayed healing in 1 case,there is no statistically significant differen ce(P>0.05).Postoperative limb function excellent,good,passable,poor respecti vely is: 25 cases,5 cases,2 cases,0 cases;24 cases,4 cases,1 case,0 cases.T he rate of qualified service respectively is 96.9%,96.6%,there is no statisticall y significant difference(P>0.05),showed that the rate of limb function in both g roups is equivalent.The patients in group A is not suffered with incision infect ion,while group B appears 2 cases.There is no statistically significant differen ce(P=0.222>0.05).Group A has 2 cases of distal locking screw loosening,but no screw breakage,while there no one appears loosening of internal fixation an d screw breakage in group B,there is no statistically significant difference signi ficantly(P=0.493>0.05).3 cases in group A feelknee joint pain,while no one f eel pain in group B,there is no statistically significant difference(P = 0.239>0.05),there is no difference in knee pain occur rate.Comparing the postoperative complications,ankle joint angulation deformity,there is no statistically significa nt difference(P = 0.138>0.05),two groups of patients with postoperative incide nce of ankle joint angulation deformity.Fracture healing delayed respectively in the two groups appears 1 case,two groups of patients are no lower extremity deep vein thrombosis,there is no statistically significant difference(P>0.05).All cases in both groups about the overall incidence of postoperative complications is respectively 12.5% and 10.3%,there is no statistically significant difference(P=0.315>0.05).It shows that there is no obvious difference between group A a nd group B on the postoperative complications.Conclusion: Two kinds of minimally invasive surgery are the effective inte rnal fixation for the treatment of tibial fractures in the middle and distal segme nt.MIPPO technology about operating time and intraoperative blood loss relativ ely is less than intramedullary nail.