Comparsion of minimally invasive percutaneous osteosynthesis and supercutaneous plating with closed reduction in treatment of distal tibial comminuted fractures / 局解手术学杂志

ABSTRACT

Astract:Objective To compare the clinical efficacy of minimally invasive percutaneous osteosynthesis and supercutaneous plating with closed reduction in the treatment of distal tibial comminuted fractures. Methods A total of 40 patients with close distal tibial comminuted fractures in our hospital from April 2012 to April 2014 were divided into minimally invasive percutaneous osteosynthesis group and external fixation group. External fixation group were treated by supercutaneous plating,while the minimally invasive percutaneous osteosynthesis group were treated by minimally invasive percutaneous osteosynthesis. And the operative duration,hospital stay,the time of weight loading and frac-ture healing,postoperative complications and function of ankle were compared between the two groups. Results In the supercutaneous plating group,the operative duration was (60. 17 ± 5. 64) minutes,the hospital stay was (8. 651 ± 2. 21) days,the time of weight loading was (49.26 ±9.85)days,the time of fracture healing was (13.82 ±4.23)weeks,the incidence of postoperative complications was 5.00%,and the excellent and good rates was 95. 00%. In the minimally invasive percutaneous osteosynthesis group,the operative duration was (74. 64 ± 6. 82)minutes,the hospital stay was (18. 22 ± 2. 32)days,the time of weight loading was (57. 56 ± 11. 32)days,the time of fracture healing was (17. 47 ± 2. 31)weeks,the incidence of postoperative complications was 25. 00%,and the excellent and good rates was 80. 00%. There were significant differences in operative duration(χ2 =9. 922,P=0. 007),hospital stay(χ2 =10. 48,P=0. 015),time of weight loading (χ2 =14. 618,P=0. 001) and fracture healing(χ2 =40. 16,P=0. 000) between the two groups. The AOFSA score of supercutaneous plating group was (89. 1 ± 3. 9)point,compared with (90. 5 ± 4. 1)point of minimally invasive percutaneous osteosynthesis group,and the difference was statistically significant(χ2 =0. 463,P=0. 793). Conclusion Distal tibial fractures may be treated successfully with minimally invasive plate osteosynthesis or supercutaneous plating. However,supercutaneous plating offers multiple advantages in terms of mean operative dura-tion,hospital stay,the time of weight loading and fracture healing.