Comparison of Anatomic Locking Titanium Plate and Intramedullary Nail in the Treatment of Distal Tibial Fractures
[Objective]To compare the clinical efficacy and complications of anatomic locking titanium plate(herein-after referred to as"titanium plate screw")and intramedullary nail in the treatment of distal tibial fractures.[Methods]From September 2019 to September 2021,32 patients diagnosed with AO-A fracture of distal tibia at Sun Yat-sen Memo-rial Hospital of Sun Yat-sen University were included in this study.Of these,15 cases were treated with titanium plate screws and 17 cases were treated with intramedullary nails.General surgical indexes,fracture healing time and postopera-tive operation were compared between the two groups.[Results]All patients were followed up for 10 to 20 months,with an average of 12 months.The operative time and intraoperative fluoroscopy times of intramedullary nail group were longer than those of titanium plate screw group,but the preoperative waiting time and hospitalization days was less or were fewer than those of titanium plate screw group,the difference was statistically significant(P＜0.05).There was no significant differ-ence in fracture healing time between the two groups(P＞0.05).At 6 weeks after operation,VAS scores in both groups were lower than those before operation,with statistically significant difference(P＜0.05).There was no significant differ-ence in VAS scores between the intramedullary nail group and the titanium plate screw group(P＞0.05).AOFAS scores 6 months after surgery,ankle joint motion and complication rate 1 year after surgery in intramedullary screw group were bet-ter than those in titanium plate screw group,and the differences were statistically significant(P＜0.05).There was no sig-nificant difference in AOFAS scores between the two groups at 1 year after operation(P＞0.05).[Conclusions]Titanium plate screw and intramedullary nail are both effective methods for the treatment of distal tibial AO-A fracture,and there is no significant difference in long-term clinical efficacy.Intramedullary nail has fewer soft tissue complications,less impact on ankle motion,faster recovery and higher safety,while titanium plate screw has a higher probability of postoperative soft tissue infection.We suggest that in clinical work,preoperative evaluation of patients should be done well.Under the prem-ise of grasping the indications,intramedullary nail has fewer complications and certain advantages.
万方数据
维普
