Comparison Of Minimally Invasive Percutaneous Locking Anatomical Plate And Interlocking Intramedullary Nail In The Treatment Of Lower Tibial Fracture

Objective:To compare the clinical efficacy of minimally invasive percutaneous anatomical plate osteosynthesis(MIPPO)and interlocking intramedullary nail(IMN)in the treatment of lower tibial fractures.Methods: A total of 37 patients with tibial lower segment fractures who were admitted to the First Affiliated Hospital of Xinjiang Medical University and Changji Branch Hospital from December 2020 to March 2022 were prospectively selected and randomly divided into two groups based on their admission numbers.The single number patients were treated as MIPPO group,with a total of 20 cases.The surgical treatment method was minimally invasive percutaneous locking anatomical plate internal fixation,and the double number patients were treated as IMN group,with a total of 17 cases,The surgical treatment method is closed reduction and interlocking intramedullary nail fixation.According to the perioperative parameters of the two groups of patients,postoperative complications,partial weight bearing time,fracture healing time,and complete weight bearing time,the therapeutic effect is evaluated using Johner Wruhs functional score and VAS pain visual simulation score.Results:All 37 patients were followed up for an average follow-up time of 13.2(12-18)months,and all patients achieved bone healing.There was a statistically significant difference(P<0.05)in perioperative and short-term efficacy between the MIPPO group and the IMN group in terms of surgical time,intraoperative bleeding,and partial weight-bearing time(P<0.05).There was no statistically significant difference(P>0.05)between the two groups in terms of hospital stay,fracture healing time,complete weight-bearing time,and 1-year postoperative Johner Wruhs functional score.In terms of postoperative VAS pain visual simulation score,The difference was statistically significant at 3 days and 1 month after surgery(P<0.05),but there was no significant difference at 3 months and 6 months after surgery(P>0.05).Conclusion:Both treatment methods are excellent for treating lower tibial fractures.MIPPO treatment is more effective in terms of surgical time,intraoperative bleeding,no knee joint pain after surgery,and reduced deformity healing rate.However,IMN treatment is superior to MIPPO in terms of early weight bearing and no subcutaneous foreign body sensation in the anterior tibia;Each has its own advantages and disadvantages,and the surgeon can choose the personalized and most suitable treatment method based on the patient’s specific situation and their proficiency in the surgical method.