Treatment of tibial shaft fractures with minimal invasive plate technique

Abstract

Objective To evaluate the treatment effects of minimal invasive plate technique on tibial shaft fractures. Methods A retrospective case-control study was made on 120 patients with tibial shaft fractures treated from September 2012 to February 2015. There were 70 males and 50 females, with age range of 21 to 61 years [(42.18±10.76)years]. There were 65 cases injured in traffic accidents, 28 in fall from height, and 27 in sports crashes. The time from injury to operation was 1 to 5 days [(2.49±1.30)days]. All fractures were type C2 by AO classification. The patients were assigned to minimally invasive plate fixation (minimal invasion group) and traditional reduction and internal fixation (tradition group), according to the treatment difference. The amount of intraoperative bleeding, operation time, hospitalized time, fracture union time, visual analogue scale (VAS) and Johner-Wruhs function score were recorded. Results Minimal invasion group showed significant differences from tradition group in aspects of amount of intraoperative bleeding [(63.26±6.84) ml vs. (187.46±25.47) ml], operation time [(58.37±6.21)min vs. (90.30±8.47)min], hospitalized time [(7.24±1.29)days vs. (8.63±1.42)days] and fracture union time [(10.26±1.82)weeks vs. (13.24±2.07)weeks](P<0.05). There were significant differences between minimal invasion group and tradition group in VAS at postoperative 1, 3, and 5 days [(4.03±0.65)points vs. (4.98±0.72)points; (2.92±0.51)points vs. (3.93±0.60)points; (1.84±0.32)points vs. (3.01±0.48)points] (P<0.05). The excellence rate by Johner-Wruhs function scale was 93.3%(36 cases as excellent, 20 good, three fair, and one poor)in minimal invasion group and 81.7%(16 cases as excellent, 33 good, eight fair, and three poor)in tradition group (P<0.01). Conclusion Minimally invasive plate technique can effectively decrease trauma and perioperative pain, and is beneficial for bone union in tibial shaft fractures. Key words: Tibial fractures; Fracture fixation, internal; Surgical procedures, minimally invasive