Comparison of effects of minimally invasive percutaneous plate fixation and interlocking intramedullary nail internal fixation in treatment of patients with distal tibia extra-articular fractures
Objective:To compare the effects of minimally invasive percutaneous plate osteosynthesis(MIPPO)and interlocking intramedullary nail(IIN)internal fixation in treatment of patients with distal tibia extra-articular fractures.Methods:The clinical data of 106 patients with distal tibia extra-articular fractures admitted to the hospital from June 2019 to January 2022 were retrospectively analyzed.According to different surgical methods,they were divided into study group and control group,53 cases in each group.The control group was treated with IIN internal fixation,while the study group was treated with MIPPO.The levels of surgery-related indexes,inflammatory factors[interleukin-1β(IL-1β),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and bone metabolic factors[β-collagen degradation products(β-CTX),bone gla protein(BGP),bone morphogenetic protein-2(BMP-2)],the ankle function(Kofoed score),and the incidence of complications were compared between the two groups.Results:The operation time and the hospitalization time of the study group were shorter than those of the control group,the fracture healing time was longer than that of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in intraoperative bleeding between the two groups(P>0.05).24 h after the surgery,the levels of serum CRP,TNF-α and IL-1β in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).3 months after the surgery,the levels of β-CTX in the two groups were lower than those before the surgery,but that in the study group was higher than that in the control group;the levels of BGP and BMP-2 in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group;and the difference was statistically significant(P<0.05).There were no significant differences in Kofoed score between the two groups 1,6 and 12 months after the surgery(P>0.05).The incidence of malunion in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:MIPPO in the treatment of the patients with distal tibia extra-articular fractures can shorten the operation time and the hospitalization time,reduce the levels of inflammatory factors and the incidence of malunion.It is superior to IIN internal fixation,but the fracture healing time needs to be prolonged.
NETL
NSTL
万方数据
维普
