Comprison Of Self-navigated Plate And Less Invasive Stabilization System In The Treatment Of Tibial Fractures

Background : In the treatment of tibial fractures, less invasive stabilization system(LISS) with minimally invasive plate osteosynthesis (MIPO) technique provides an alternative method and satisfactory outcome. However LISS posts a heavy ecnomic burden on patients. To gain advantage of the LISS system but at lower cost, we introduce a new kind of plate, which is characterized by the presence of a groove at each end of the plate, named by the self-navigated plate. The percutaneous plating technique is developed to treat tibial fractures. This new plate, after inserted subperiosteally can be fixed in the proper place with two K-wires inserted into the grooves.Methods The study included 41 cases of tibial fractures treated between September 2009 and May 2010 with either self-navigated plate (21 cases of Group I) or LISS (20 cases of Group II). In Group I, the self-navigated plate is inserted subperiosteally across the fracture line when the fracture is effectively reduced. A second plate of the same is then placed over the subcutaneous one and serves as a guide for pecrutaneous insertion of screws through the holes of subperiosteal plate into the bones to secure the fracture. In Group II, conventional surgical technique which was described in detail in previous publications was used in the treatment of these fractures. The two Groups were compared in duration of operation, anesthesia time,blood lose, time of the bony union, incidence of complications and postoperative function.Result The duration of operation was 59.0min (30–110min) in Group I and 79.5 min (40–130min) in Group II(P=0.006). The anesthesia time was 76.0min (40-130min) in Group and 98.3min(60-150) in Group II(P=0.018). The blood lose was 54.3ml(30-100ml) in Group I and 59.5ml (40-90ml) in Group II(P=0.279). At a mean of 15.5 months of follow-up (range, 12-19 months), all the fractures united.. The time of the bony union was 11.9 weeks (range, 9–16 weeks) in Group I and 12.5 weeks (range, 9–17 weeks) in Group II (p=0.457). 18 of the 21 patients (85.7%) in Group I got excellent and good results and 19 of the 20 patients (95%) in Group II got excellent and good results (p=0.3165).Conclusion Self-navigated plate provides a good and effective alternative for treatment of tibial fractures with advantages in the aspects of duration of operation, blood of lose, fracture healing, complications rate and good outcomes. Its economical-friendly feature is helpful to its wide application in the treatment of tibial fracture.