Abstract：Objective To compare the efficacy of intramedullary nail (IMN) and minimally invasive plate osteosynthesis(MIPO) in the treatment of 42A1 and 42B1 tibial shaft fractures classified by Arbeitsgemeinschaftfür OsteSyntheefragen(AO).Methods The clinical data of 52 patients with AO type 42A1 and 42B1 tibial shaft fractures treated in the Second People′s Hospital of Changzhi City from January 2007 to January 2017 were retrospectively analyzed.According to different treatment methods,they were divided into MIPO group and IMN group,with 26 cases in each group.The methods of anesthesia,operation time and the time of callus formation were compared between the two groups.The infection,malunion and delayed healing of the two groups were compared,and the lower limb function score (LEFS) of the two groups were compared after 6 months and 2 years of follow-up.Results There was no significant difference in anesthesia mode between two groups (P＞0.05).The operation time of MIPO group was longer than that of IMN group,the difference was statistically significant (P＜0.05).There were no significant differences in the follow-up time and the time of callus formation between the two groups (P＞0.05).There were no significant differences in infection,malunion and delayed union between the two groups (P＞0.05).The postoperative anatomical reduction rate of MIPO group was higher than that of IMN group,and the incidence of anterior knee pain was lower than that of IMN group,the difference was statistically significant (P＜0.05).After 6 months of follow-up,the LEFS score of MIPO group was lower than that of IMN group,the difference was statistically significant (P＜0.05),but there was no significant difference of LEFS score between the two groups after 2 years of follow-up (P＞0.05).Conclusion MIPO and IMN are similar in clinical and functional results,and MIPO can effectively avoid specific complications caused by IMN in some aspects,MIPO is recommended as an alternative to IMN in the treatment of AO type 42A1 and 42B1 tibial shaft fractures.
秦慧永；王俊生；宋晓亮. 髓内钉和微创钢板内固定治疗42A1型和42B1型胫骨干骨折的效果比较[J]. 中国当代医药, 2022, 29(17): 92-96.
QIN Huiyong； WANG Junsheng ；SONG Xiaoliang. Effect comparison of minimally invasive plate internal fixation and intramedullary nail in the treatment of 42A1 and 42B1 tibial shaft fractures. 中国当代医药, 2022, 29(17): 92-96.
Wang JQ，Chen ZX，Guo WJ，et al.Comparison of plate and intramedullary nail fixation of extra-articular tibial fractures：A retrospective study exploring hidden blood loss[J].Injury，2019，50（20）：546-550.
[2]
Johal H，Bhandari M，Tornetta P，et al.Cochrane in CORRR：Intramedullary Nailing for Tibial Shaft Fractures in Adults（Review）[J].Clin Orthop Relat Res，2017，47（5）：585-591.
[3]
Liu XK，Xu WN，Xue QY，et al.Intramedullary nailing versus minimally invasive plate osteosynthesis for distal tibial fractures：a systematic review and meta-analysis[J].Orthop Surg，2019，11（1）：954-965.
[4]
Meena RC，Meena UK，Gupta GL，et al.Intramedullary nailing versus proximal plating in the management of closed extra-articular proximal tibial fracture：a randomized controlled trial[J].J Orthop Traumatol，2015，16（2）：203-208.
[5]
Kandemir U，Herfat S，Herzog M，et al.Fatigue failure in extra-articular proximal tibia fractures：Locking intramedullary nail versus double locking plates-a biomechanical study[J].J Orthop Trauma，2017，31（5）：49-54.
[6]
Beytemür O，Albay C，Adanir O，et al.Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?[J].Eklem Hastalik Cerrahisi，2016，27（2）：125-131.
[7]
Galal S.Minimally invasive plate osteosynthesis has equal safety to reamed intramedullary nails in treating Gustilo-Anderson type Ⅰ，Ⅱand Ⅲ-A open tibial shaft fractures[J].Injury，2018，49（2）：866-870.
[8]
Shen J，Xu J，Tang MJ，et al.Extra-articular distal tibia facture （AO-43A）：A retrospective study comparing modified MIPPO with IMN[J].Injury，2016，47（1）：235-239.
Im GI，Tae SK.Distal metaphyseal fractures of tibia：a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screws fixation[J].J Trauma，2005，59（5）：1219-1223.
Duygun F，Aldemir C.Effect of intramedullary nail compression amount on the union process of tibial shaft fracture and the evaluation of this effect with a different parameter[J].Eklem Hastalik Cerrahisi，2018，29（2）：87-92.
[13]
Kulkarni SG，Varshneya A，Kulkarni S，et al.Intramedullary nailing supplemented with Poller screws for proximal tibial fractures[J].J Orthop Surg （Hong Kong），2012，20（1）：307-311.
[14]
Minhas SV，Ho BS，Switaj PJ，et al.A comparison of 30-day complications following plate fixation versus intramedullary nailing of closed extra-articular tibia fractures[J].Injury，2015，46（1）：734-739.
[16]
Hasenboehler E，Rikli D，Babst R.Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture：a retrospective study of 32 patients[J].Injury，2007，38（3）：365-370.
[17]
Kuo LT，Chi CC，Chuang CH.Surgical interventions for treating distal tibial metaphyseal fractures in adults[J].Cochrane Database Syst Rev，2015，3（1）：CD010261.
Pan SL，Liang HW，Hou WH，et al.Responsiveness of SF-36 and Lower Extremity Functional Scale for assessing outcomes in traumatic injuries of lower extremities[J].Injury，2014，45（1）：1759-1763.
[20]
Smith MV，Klein SE，Clohisy JC，et al.Lower extremityspecific measures of disability and outcomes in orthopaedic surger[J].J Bone Joint Surg Am，2012，94（1）：468-477.
[21]
Wen H，Zhu S，Li C，et al.Antegrade intramedullary nail versus plate fixation in the treatment of humeral shaft fractures：An update meta-analysis[J].Medicine （Baltimore），2019，98（46）：e17952-e17957.
京公网安备 11010502046607号