Abstract:

BACKGROUND: High-energy comminuted fracture of tibia and fibula is often associated with soft tissue injury, the improper reduction method during the operative process of internal fixation can cause secondary soft tissue damage, resulting in serious consequences such as: skin infection and necrosis, bone exposure, osteomyelitis, bone defects and others; Looking for a way both to achieve stable internal fixation, and avoid aggravated soft tissue damage is the object of study for orthopaedic surgeon.
OBJECTIVE: To investigate the clinical therapeutic effect of external fixation combined with MIPO technology used in complex tibial and fibular fracture.
METHODS: Retrospective analysis was used in 39 cases of complex comminuted fracture of tibia and fibula selected from Guangzhou First People’s Hospital Affiliated to Guangzhou Medical College. In the minimally invasive internal fixation surgery, the temporary external fixation assisted reduction technology combined with MIPO technology used in all cases, and be removed after internal fixed firmly.
RESULTS AND CONCLUSION: All the 39 patients were followed up covering a period from 6 to 18 months with an average of 12 months. Results show the osteological healing of 36 cases reached grade A primary intention healing with slightly affected limb swelling; 2 cases of wound edge swelling, healing by scar; 1 case of acute osteomyelitis in 3 months, healing after conservative anti-inflammatory therapy; none appeared operatively fixator nail hole infection, screw loosening and incision infection, skin necrosis, exposed bones and tendons. According to AOFAS ankle score, at 6 months after plate implantation, the ankle joint recovery condition was as follows: excellent in 29 cases, good in 8 cases, fair in 2. Range of ankle flexion and extension was ≥ 30° in 29 cases, 20° to 30° in 8 cases, and 20° or less in 2 cases.