Application value of internal and lateral percutaneous minimally invasive plate internal fixation for type A closed distal tibial fracture

  Objective  To investigate the effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of type A closed distal tibial fractures.

  Methods  A total of 88 patients with type A closed distal tibial fracture diagnosed and treated in orthopedics and traumatology department in our hospital were treated with MIPPO surgery combined with internal fixation of Locking Compression Plate (LCP), and were divided into internal fixation group (n=44) and lateral fixation group (n=44) by simple random grouping method. The operative time, bleeding volume, Visual Analogue Scale (VAS) scores, fracture healing time, complications and ankle-hind foot function score of American Orthopedic Foot and Ankle Society (AOFAS) of the two groups were compared.

  Results  The operation time, bleeding volume and fracture healing time of internal fixation group were significantly better than those of lateral fixation group (P < 0.05). There was no significant difference in VAS score between the two groups at 1 day after operation (P>0.05). Both groups were followed up successfully for more than 6 months. The average follow-up time was 8.35 months in internal fixation group, and 8.29 months in lateral fixation group. There were no significant differences in incision infection, plate bending, delayed healing, ankle pain and total complication rate between medial fixation group and lateral fixation group(P>0.05). There was no significant difference in AOFAS scores at last follow-up between two groups(P>0.05).

  Conclusion  The short-term efficacy of MIPPO for type A closed distal tibial fracture is similar, but internal fixation has advantages in shortening operation time, reducing operative bleeding and promoting fracture healing.