Abstract:

BACKGROUND: Minimally invasive percutaneous plate osteosynthesis (MIPPO), intramedullary nail fixation (INF) and open reduction and plate fixation (ORPF) are the effective treatments for distal tibial fracture with different advantages and disadvantages, respectively. OBJECTIVE: To compare the different clinical outcomes of MIPPO with INF and ORPF for treatment of distal tibial fractures.
METHODS: From March 2007 to May 2010, 85 cases of distal tibial fracture treated with MIPPO (n=25), INF (n=31) and ORPF (n=29) were selected. The indexes of surgical trauma, systemic inflammatory response, functional recovery of tibia, soft tissue injury and union of fractures were compared among the three groups.
RESULTS AND CONCLUSION: The MIPPO, INF and ORPF were all effective treatments for distal tibial fractures. There were no significant differences of the indexes in surgical trauma, soft tissue injury and functional recovery of tibia between the MIPPO and INF groups, but both were better than those of the ORPF group. In terms of fracture healing, there were no differences among the 3 groups in the treatment of type A distal tibial fracture, but obvious advantages were found in the treatment of type B and C fractures in the MIPPO and INF groups as compared with the ORPF group. MIPPO are found to have minimal surgical trauma and soft tissue injury, slighter postoperative systemic inflammatory response, better functional recovery of tibia and faster fracture healing but facing challenge of reduction intraoperatively and increasing risk of malunion postoperatively.