Objective To compare the efficacy of locking intramedullary nail and minimally invasive percutaneous plate osteosynthesis in treating middle-distal tibial fractures.Methods The 100 patients with middle-distal tibial fractures were divided into two groups according to different internal fixation methods:the interlocking intramedullary nail group(50 cases were treated with interlocking intramedullary nail fixation)and the locking plate group(50 cases were treated with minimally invasive percutaneous locking plate internal fixation).The surgical conditions,fracture healing time,postoperative partial weight-bearing walking time,postoperative complications,Johner-Wruhs score,ankle joint activity and AOFAS ankle-hindfoot score were compared between the two groups.Results All patients were fol-lowed up for12～15(12.26±5.63)months.The intraoperative bleeding volume,incision length,the hosptialization time in the interlocking intramedullary nail group were less(shorter)than those of the locking plate group(P<0.01).The fractures healing time of interlocking intramedullary nail group group was shorter than locking plate group(P<0.01).The partial weight-bearing walking time of interlocking intramedullary nail group group was earlier than that of the locking plate group(P<0.01).The postoperative complications incidence rate in the interlocking intr-amedullary nail group was lower than the locking plate group(P<0.05).The excellent-good rate of Johner-Wruhs scores at the postoperative 12 months,ankle joint activity at the last follow-up and AOFAS ankle-hindfoot scores at the postoperative 3,12 months:the interlocking intramedullary nail group were all better than the locking plate group(P<0.05).Conclusions Compared with minimally invasive percutaneous plate osteosynthesis,the interlocking intramedul-lary nail in treating middle-distal tibial factures is more consistent with the mechanical principle,and it is more benefi-cial to fractures healing,the postoperative walking time is earlier,with fewer complication and better recovery of the an-kle function.
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