Expert Tibia Nail For The Treatment Of The Lower Third Tibia Fractures

Objective:By comparing the clinical outcomes of two osteosynthesis systems developed for surgical treatment of the lower third tibia fractures:the Expert tibia nail (ETN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) in the distal tibia,to explore the clinical application and efficacy of ETN for the treatment of the distal third tibia fractures with closed reduction,to provide references for the choice in the treatment of the lower third tibia fractures.Methods:45 fractures in the lower third tibia meeting the inclusion and exclusion criteria were included in this prospective study.Patients, divided into study group (treated with ETN) and control group (treated by LCP) according to different treatment, were all treated by operations,of them 21 cases in the study group and 24 in the control group.Operation duration,intra-op bleeding, intra-op number of radiation, duration of hospital stay,weight bearing time,the time taken for radiological union and post-op complications (incision infections,skin necrosis,malunion,et al) are used in analysis.The post-op rehabilitation and function were evaluated by Johner-Wruhs grade criteria and Mazur Scores (1979).Statistical processing adopt SPSS11.5.Results:This group of 45 cases,21 in the study group and 24 in the control group,was all followed up for 12.5 months on average (ranged,6-18 months).All the patients achieved bony union.We found both the systems are near same as far as intra-op relevant indicators,post-op complications,Johner-Wruhs grade criteria and Mazur Scores, but statistical difference was found with the time taken for radiological union and preoperative hospital duration (P<0.05).Bony union was found on the radiograph in the study group by (19.3±3.1) weeks and in the control group at (24.6±9.02) weeks,at an average.preoperative hospital duration in the former by (4.86±1.71) days and in the latter at (6.04±2.12) days.Conclusion:With closed reduction,ETN for treatment of the lower third tibia fractures,is beneficial to a fixed stability,a small soft tissues damage,a high rate of union and a low rate of malunion,thereby is one of good internal fixation choice, particularly,is the choice of implant with the worse soft tissue coverage not appling to plate early.