| Objectives:To investigate the effects of 3 internal fixation methods in minimally invasive treatments for middle and lower tibial spiral fractures..Methods:Retrospective analyses were made on all the cases of minimally invasive treatments for middle and lower tibial spiral fractures using common interlocking intramedullary needle,L anatomic locking plate,and the distal tibia lateral locking plate in our hospital from 2013.01.01 to 2016.01.01.And statistical analyses were conducted on relevant factors such as operational duration,intraoperative blood loss,intraoperative fluoroscopy times,extraction time of drainage tube after the operation,postoperative hospital stay,time of the second operation,Johner Wruhs score.Results:85 cases complied with the inclusion criteria and exclusion criteria including 31 cases of common interlocking intramedullary needle,35 cases of 1-type anatomical locking plate and 19 cases of distal tibial lateral anatomical locking plate.A total of 84 cases achieved osseous healing within 6 months.The other 1 case showed bone nonunion and steel plate fracture 7 month after the operation.Of all the 85cases,33 cases presented varying degrees of fracture malunion,2 cases postoperative infection and 1 case occasional knee pain.According to Johner-Wruhs functional assessment criteria,4 cases were poor,9 cases were fair,24 cases were good,while 48 cases were excellent.The function of L type anatomical locking plate group was better than that of the other 2 groups,and P<0.05.Conclusion:Comparison among the 3 internal fixation methods in minimally invasive treatment for distal tibial spiral fracture shows that L type locking plate has the following advantages:applicable in complex type of fracture,smaller trauma,less bleeding,less fluoroscopy,fixation stability after fracture reduction,shorter postoperative hospital stay,better soft tissue and fracture healing,and more satisfactory limb function recovery. |
PDF Full Text Request