Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (12): 1864-1868.doi: 10.3969/j.issn.2095-4344.3772

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Minimally invasive percutaneous plate osteosynthesis and elastic nail system in the treatment of distal tibiofibular fracture in adults 

Wang Lei, Qi Rong, Li Jia, Qiu Zhixue, Wang Kai, Suo Nanangxiu   

  1. Department of Orthopedics, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
  • Received:2020-04-11 Revised:2020-04-21 Accepted:2020-06-03 Online:2021-04-28 Published:2020-12-25
  • Contact: Suo Nanangxiu, Chief physician, Department of Orthopedics, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
  • About author:Wang Lei, Associate chief physician, Department of Orthopedics, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
  • Supported by:
    the Research Project of Health and Family Planning of Qinghai Health Committee, No. 2017-wjzdx-05 (to SNAX)

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Abstract: BACKGROUND: Minimally invasive treatment of distal tibiofibular fractures has always been a hot spot in clinical research. Closed reduction and minimally invasive fixation is a real minimally invasive treatment, but there are deficiencies in long-term follow-up.
OBJECTIVE: To explore the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) technology and elastic nail system in the treatment of tibiofibular fracture in adults. 
METHODS: Twenty-five adult patients with distal tibiofibular fractures were treated with MIPPO technique combined with elastic intramedullary nailing. AO classification: There were 18 cases of type A, 7 cases of type B, and 0 case of type C. All patients were given symptomatic treatment after operation, and the patients were instructed to carry out rehabilitation training of lower limb function. X-ray films were taken at 1, 3, 6, and 12 months after operation, and the weight-bearing time was determined according to the fracture healing. At the last follow-up, Johner-Wruhs score and Phillips score were used to evaluate ankle function.
RESULTS AND CONCLUSION: (1) After 15-28 months of follow-up, all patients had limited weight bearing of lower limbs (10 kg) after 8 weeks of the operation. (2) The fracture healing time of AO type A patients was significantly shorter than that of AO type B patients (P < 0.05). (3) According to Johner-Wruhs criteria at the last follow-up, 21 cases were excellent and 4 cases were good. (4) The ankle joint function was evaluated according to the Phillips score at the last follow-up after operation. Totally 19 cases were excellent, 4 cases were good, and 2 cases were average. Among them, the total excellent and good rate of Phillips score at the last follow-up was 94% in AO type A patients, and 86% in AO type B patients; the difference was significant (P < 0.05). (5) There were no incision problems, nonunion of fracture ends, failure of internal fixation or other complications in all patients. (6) It is concluded that MIPPO technology and elastic nail system in the treatment of tibiofibular fracture has high healing rate, and fast functional recovery. It conforms to the principle of rapid trauma recovery, and this method is more advantageous in AO type A patients. 


Key words: bone, tibia, fibula, fracture, internal fixation, plate, elastic intramedullary nail, ankle joint

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