The Clinical Investigation For The Treatment Of High-energy Tibial Fracture With MIPPO Technique

Objective: To compare the clinical effect of higher-energy tibialfractures treated with common bone setting board stationary with openreduction and internal fixation and minimally invasive percutaneus plate.(MIPPO) technique with LCP bone setting board stationary and provideclinical evidence for the treatment of high-energy shin bone fractureswith MIPPO technique.Methods: From January2008to August2010,85cases of high-energytibial fractures who were hospitalization and operated in our hospitalwere included in this study through prospective analysis.80patients werefollowed up. The patients were divided into normal group and minimallyinvasive precutaneus plate(MIPPO) technology group,41cases wereordinary plate operation group,25patients of plate were placed medialtibial,16patients of plate were placed lateral;39cases were MIPPOtechnology group, medial malleolus or tip of the proximal tibial cut of36patients were selected. LCP plate was placed in the medial tibia,3cases ofsoft tissue contusion medial tibia were placed severe lateral tibia. Bloodloss, surgical complications and fracture healing time were analyzed intwo groups. Johner and Wruhs functional assessment of standards wereutilized. Results:80patients were followed up from8to24months, on anaverage of13.4±3.2months. The operation time of ordinary plate was50~120(73.5±10.1) minutes and MIPPO operative time was45~130(75.3±9.8) minutes. The difference was not significant (P>0.05). Meanblood loss volume of normal bone plate group was208.6±16.4ml,MIPPO group was107.4±11.3ml.Differences are significant in bloodloss between two groups(P <0.05). Group of ordinary plate fracturehealing time was18~28(18.3±4.8) weeks, MIPPO group was10~18(13.2±3.1) weeks.There were significant differences between two groups(P <0.05). Complication rate of fracture in normal bone plate group was21.95%and MIPPO group was5.12%, the difference was significant (P<0.05).There were not significant differences between two groups ingeneral functional assessment of fracture healing(p>0.1).Conclusion:1.MIPPO technology of high-energy tibial shaft fracturescompared with ordinary titanium plate had less trauma, less blood loss,fewer complications,and faster fracture healing.2. MIPPO technology isan alternative treatment for high-energy tibial shaft fractures fromfunctional evaluation point.