Objective  To investigate the difference of surgical effect between intramedullary nail (IMN) and minimally invasive percutaneous plate osteosynthesis(MIPPO) in the treatment of middle or lower tibial fractures.

  Methods  A total of 80 patients with middle or lower tibial fractures admitted to our hospital were divided into IMN group (n=40) and MIPO group (n=40) according to radom table methal. All patients were followed up for 6 months in outpatient department. The indexes of operation and hospitalization, fracture healing time and surgery-related complications were compared between the two groups. Johner-Wruhs scoring system was used to evaluate ankle function after operation.

  Results  There were no significant differences in hospitalization time, callus formation time and fracture healing time between the two groups (P>0.05). The operation time and bleeding volume were (63.28±9.75) min, (87.32±16.42) mL, respectively, in MIPPO group, which were better than (71.16±11.23) min and (102.58±20.37) mL, respectively in IMN group(P < 0.05). All the patients were successfully followed up for 6 months, and no cases with malunion and internal fixation failure occurred. The complication rates of IMN group and MIPPO group were 7.50% and 12.50% respectively, and showed no significant difference between the two groups (P>0.05). Postoperative Johner-Wruhs scoring showed that the excellent recovery rate of ankle joint function in IMN group and MIPPO group was 90.00% and 92.50%, respectively, showing no significant difference between the two groups (P>0.05).

  Conclusion  Both IMN and MIPPO are effective internal fixation for the treatment of middle and lower tibial fractures, and have similar effects in hospitalization time, fracture healing, surgical complications and recovery of ankle function. However, MIPPO has the advantage of shortening the operation time and reducing the amount of bleeding.