Comparison of Anatomic Locking Titanium Plate and Intramedullary Nail in the Treatment of Distal Tibial Fractures
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240004.016
- VernacularTitle:解剖型锁定钛板与髓内钉治疗胫骨远端骨折的疗效比较
- Author:
Mengjun MA
1
;
Yanbo CHEN
2
;
Gang ZENG
2
;
Chen CHEN
2
;
Weidong SONG
2
;
Wenzhou LIU
2
Author Information
1. Orthopaedic Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
2. Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China
- Publication Type:Journal Article
- Keywords:
distal tibial fractures;
anatomical locking titanium plate;
intramedullary nail;
treatment;
efficacy
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2024;45(1):108-113
- CountryChina
- Language:Chinese
-
Abstract:
ObjectivesTo compare the clinical efficacy and complications of anatomic locking titanium plate （hereinafter referred to as “titanium plate screw”） and intramedullary nail in the treatment of distal tibial fractures.Methods From September 2019 to September 2021， 32 patients diagnosed with AO-A fracture of distal tibia at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were included in this study. Of these， 15 cases were treated with titanium plate screws and 17 cases were treated with intramedullary nails. General surgical indexes， fracture healing time and postoperative operation were compared between the two groups.ResultsAll patients were followed up for 10 to 20 months， with an average of 12 months. The operative time and intraoperative fluoroscopy times of intramedullary nail group were longer than those of titanium plate screw group， but the preoperative waiting time and hospitalization days was less or were fewer than those of titanium plate screw group， the difference was statistically significant （P < 0.05）. There was no significant difference in fracture healing time between the two groups （P> 0.05）. At 6 weeks after operation， VAS scores in both groups were lower than those before operation， with statistically significant difference （P<0.05）. There was no significant difference in VAS scores between the intramedullary nail group and the titanium plate screw group （P> 0.05）. AOFAS scores 6 months after surgery， ankle joint motion and complication rate 1 year after surgery in intramedullary screw group were better than those in titanium plate screw group， and the differences were statistically significant （P< 0.05）. There was no significant difference in AOFAS scores between the two groups at 1 year after operation （P> 0.05）.ConclusionTitanium plate screw and intramedullary nail are both effective methods for the treatment of distal tibial AO-A fracture， and there is no significant difference in long-term clinical efficacy. Intramedullary nail has fewer soft tissue complications， less impact on ankle motion， faster recovery and higher safety， while titanium plate screw has a higher probability of postoperative soft tissue infection. We suggest that in clinical work， preoperative evaluation of patients should be done well. Under the premise of grasping the indications， intramedullary nail has fewer complications and certain advantages.
