Percutaneous closed reduction locking compression plate, percutaneous closed reduction interlocking intramedullary nail and open reduction plate in the treatment of tibial fracture: comparison of biostability

doi:10.3969/j.issn.2095-4344.2014.44.018

Abstract

Abstract:

BACKGROUND: The distal tibia shaft fracture is prone to be comminuted after trauma due to the absence of muscle covering and the thin soft tissue, and intraoperative reduction and fixation are difficult. Clinical efficacy is closely related to the type of fracture, degree of soft tissue injury, choice of therapy and internal fixation. Internal fixation is the main treatment for the distal tibia shaft fracture, and a microinvasive, strong fixation is the focus of tibial fracture treatment although many methods for internal fixation are present.
OBJECTIVE: To explore clinical efficacy of the treatment of distal tibia shaft fracture using percutaneous locking compression plate, interlocking intramedullary nail and open reduction with internal fixation.
METHODS: A total of 180 patients with distal tibia shaft fracture were randomized into three groups, receiving internal fixation treatment using percutaneous locking compression plate, interlocking intramedullary nail or open reduction. All patients were followed up for 12-24 months. The clinical outcomes of the treated patients in three
groups were compared through the observations of incision length, operation time, intraoperative fluoroscopy time, intraoperative blood loss, complications after fixation.
RESULTS AND CONCLUSION: After excluding the loss of follow-up, 56 cases receiving percutaneous locking compression plate, 52 cases receiving interlocking intramedullary nail and 48 cases receiving open reduction were involved in the final analysis. The incision length and intraoperative blood loss in the groups of percutaneous locking compression plate and interlocking intramedullary nail were significantly better than that of open reduction (P < 0.05). Intraoperative fluoroscopy time in the group of percutaneous locking compression plate was significantly longer than that in other two groups (P < 0.05). The operation time showed no significant differences among three groups. The rate of complications was 11% in the group of percutaneous locking compression plate, and 27% in the groups of interlocking intramedullary nail and open reduction with internal fixation. Percutaneous locking compression plate is a good choice for the distal tibia shaft fracture due to small injury, good biomechanical stability, and no influence on blood supply at fracture end; interlocking intramedullary nail is also a useful technique due to simple operations. Open reduction with internal fixation should be chosen carefully due to great dissection, great influence on blood supply and high complication rate.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: tibia, fracture, internal fixators, surgery, microinvasive, follow-up studies

CLC Number:

R318

Chen Gang, Qian Ming-quan, Zhu Guo-xing, Shi Ke-qin. Percutaneous closed reduction locking compression plate, percutaneous closed reduction interlocking intramedullary nail and open reduction plate in the treatment of tibial fracture: comparison of biostability[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(44): 7151-7156.

Figures/Tables 6

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