Comparison of the effect of interlocking minimally invasive percutaneous plating and interlocking intramedul-lary nailing in the treatment of tibial fractures of the lower tibia
10.3760/cma.j.issn.1008-6706.2016.16.018
- VernacularTitle:微创经皮钢板与交锁髓内钉固定治疗胫骨下端骨折的疗效比较
- Author:
Yanshan ZHENG
- Publication Type:Journal Article
- Keywords:
Tibial fractures;
Bone wires;
Fracture fixation,intramedullary;
Comparative effectiveness research
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(16):2469-2472
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of interlocking minimally invasive percutaneous plating and interlocking intramedullary nailing in treating fractures of the lower tibia,thus to guide clinical treatment.Methods A retrospective analysis of 70 patients with tibial fractures of the lower tibia were made.All the patients were divided into interlocking minimally invasive percutaneous plating group (A group)and interlocking intramedullary nailing group (B group),35 cases in each group.The operative time,blood loss,fracture healing time,hospitalization time were compared,the ankle score after 1 month,3 months,6 months,9 months,12 months were recorded,the complica-tions(loose,broken nails,deep infection,superficial infection,delayed union,malunion,joint pain)were observed,the Johner Wruh method was used to evaluate the clinical efficacy of postoperative tibial functional recovery.Results The operative time of A group and B group were (130.2 ±40.1)min and (96.4 ±30.5)min,A group was signifi-cantly longer than B group (t =3.853,P <0.05).There were no differences between A group and B group in bleed-ing amount,fracture healing time,hospitalization time (t =0.336,0.228,1.743,all P >0.05).There were no differ-ences between A group and B group in the ankle score after 1 month,3 months,6 months,9 months,12 months(t =0.855,1.315,1.527,0.787,0.885,both P >0.05).The clinical efficacy of tibia functional recovery in A group and B group were 97.14% and 94.29%,the difference was not statistically significant (χ2 =0.354,P >0.05).The inci-dence rates of loose,broken nails,deep infection,superficial infection,delayed healing in A group and B group had no difference (χ2 =0,0.348,1.014,3.134,0.348,all P >0.05),the incidence rates of malunion and joint pain in A group and B group were 2.86% and 20%,25.71% and 48.57%,which of A group were significantly lower than B group,the differences were statistically significant (χ2 =5.081,3.916,all P <0.05).Conclusion Interlocking min-imally invasive percutaneous plating and interlocking intramedullary nailing have exact effect in treatment of tibial fractures of the lower tibia,the effect of both methods has no difference,but interlocking minimally invasive percutane-ous plating has lower rate of malunion and knee pain,and suits for fracture patients with good soft tissue condition,but interlocking intramedullary nailing suits for fracture patients with poor soft tissue condition,fracture patients with good soft tissue condition and simple fracture,should master surgical indications of both surgery.
