Clinical Comparison Of Interlocking Intramedullary Nail Versus Minimally Invasive Percutaneous Plate In The Treatment Of Middle And Lower Tibia Fracture

Objective:To investigate the efficacy of minimally invasive percutaneous plate internal fixator and interlocking intramedullary nail in the treatment of middle and lower tibia fractures.Comparing the resutls to provide the reference for clinical treatment of Tibial Fracture in the middle and distal.Methods: A retrospective study of 57 patients with fractures of the middle and lower tibia from the Affiliated Hospital of Hebei University of Engineering from September 2015 to September 2017,the patients are divided into two groups according to the surgical options: interlocking intramedullary nails(group A)and MIPPO(group B).Comparing the difference of operation time,intraoperative blood loss,X-ray perspective times,fracture healing time,postoperative complications between the two groups.And evaluating the limb function of interlocking intramedullary nails and minimally invasive percutaneous plate osteosynthesis by Johner & wruhs evaluation standard for the treatment of the middle and lower segment tibia fractures.Results:Analysis the data by using SPSS20.0 statistical software.P<0.05 showed significant difference,P<0.01 means the difference between the two grous had the remarkable significance.The results showed that there were obvious difference between two groups in operation time,blood loss and the number of perspective(P<0.05),The operation time,X-ray perspective times and blood loss in group A is higher than that in group B.But there were no significant difference between the two methords in the clinical healing time of fracture.The number of cases of limb function excellent,good,passable,poor respectively is:18 cases,7 cases,5 cases,0 cases;18 cases,5 cases,4 case,0 cases.The postoperative good rate is90%,85%,The difference was not statistically significant(P>0.05),showed that the rate of limb function in both groups is equivalent.There were 1 case of delayed union,1 cases of distal locking screw loosening,2 cases of knee pain,no postoperative infection and no venous thrombosis in interlocking intramedullary nail group;1 cases of postoperative infection,1 cases of delayed union,1 case of loosening of internal fixation in minimally invasive percutaneous plate osteosynthesis group.There was no significant difference in postoperative complications between the two groups.Conclusion:Interlocking intramedullary nail and minimally invasive percutaneous plate osteosynthesis were both excellent internal fixations in treating the tibia fractures.Comparing the former,MIPPO has shorter operative time,less intraoperative blood loss,less fluoroscopy times and other advantages.Intramedullary nail should be recommended in the patients with bad soft tissue condition and severe swelling.