| Objective: To investigate the clinical efficiency of MIPPO technology in treating multisegment fractures of the tibia, and to analyze the related factors influencing its efficiency. Methods: 1. This retrospective study was conducted on the clinical data of 58 patients with multisegment fractures of the tibia treated with MIPPO technology in the Department of Orthopaedics of the Fifth Affiliated Hospital of Zunyi Medical College(Zhuhai) between January 2010 and December 2015. 2. The data of patients were grouped according to the related factors that might influence the clinical efficiency of Mippo technology as follows:(1) gender: male group, female group;(2) age: 18-40 years old group, 41-60 years old group;(3) fracture site: middle and upper segment fractures of the tibia group, multiple fractures of the middle segments of tibia group, middle and lower segment fractures of the tibia group;(4) degree of soft-tissue injury when fracture: mild closed fracture without tense blisters group, open fracture or severe closed fracture with tense blisters group;(5) whether open fracture or not: closed fracture group, Gustilo-Anderson grade I group, Gustilo-Anderson grade II group, Gustilo-Anderson grade III group;(6) whether combined with fractures of other parts: combined with fractures of other parts group, non-combined with fractures of other parts group;(7) reduction quality: anatomical reduction group, functional reduction group, unsatisfactory reduction group;(8) operation time: emergency operation group, delayed operation group;(9) postoperative wound healing: class-A healing group, class-B healing group, class-C healing group;(10) whether external fixation or not: non-external fixation immobilized group, orthosis immobilized group, gypsum immobilized group. 3. Clinical efficiency was determined based on Johner-Wruhs evaluation criteria. 4. Univariate analysis was performed with above 10 potential related factors and the efficiency of MIPPO technology in treating multisegment fractures of the tibia, and P < 0.05 was considered as statistically significant. 5. Related factors with statistical significance were included for Logistic multifactor regression analysis to analyze the influencing factors of MIPPO technology in the treatment of multisegment fractures of the tibia. SPSS 20.0 software packages were applied for analysis; measurement data were represented with mean ± standard deviation(x ± s); enumeration data were analyzed using the chi-square test; P < 0.05 was considered as statistically significant. Results:(1) According to the Johner-Wruhs evaluation criteria, among the 58 patients with multisegment fractures of the tibia treated with MIPPO3 technology, 48 showed good efficiency, and 10 presented poor efficiency.(2) Univariate analysis in this study demonstrated that age, gender, combined with fractures of other parts, open fracture, operation time, or postoperative wound healing was not apparently correlated with postoperative efficiency of multisegment fractures of the tibia(P > 0.05); while degree of soft-tissue injury, fracture site, reduction quality and external fixation have significant influence on efficiency(P < 0.05).(3) Logistic multifactor regression analysis including degree of soft-tissue injury, fracture site, reduction quality and external fixation as well as efficiency revealed that degree of soft-tissue injury and fracture site were independent risk factors of efficiency, and reduction quality and external fixation were protective factors of efficiency.Conclusion:(1) Good fracture reduction and early functional exercise are important factors affecting the surgical outcome of multisegment fractures of the tibia;(2) To clarify the clinical characteristics of different sites of multisegment fractures of the tibia and to pay attention to perioperative soft tissue protection are also factors affecting the surgical outcome;(3) MIPPO technology is reliable in treating multisegment fractures of the tibia. |
PDF Full Text Request