Comparative Analysis of RTN and MIPPO in the Treatment of Distal Tibial Fractures

Song Haipeng; Gao Kai; Wang Ke; Liu Rujun

Abstract：Objective To compare and analyze the clinical effects of retrograde tibial intramedullary nail(RTN)and minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of distal tibial fractures.Methods A total of 102 patients with distal tibial fractures admitted to Nanyang hospital of traditional Chinese medicine from April 2022 to April 2024 were selected as the research objects,including 64 males and 48 females,aged 28 to 58 years,with an average of(43.12±6.53)years.They were divided into intramedullary nail group and plate group by random number table method,51 cases in each group.The operation indexes,as well as the C-reactive protein,interleukin-1β,visual analogue scale(VAS),American orthopedic foot and ankle society(AOFAS)score,fracture reduction quality before and after operation,and complications were compared between the two groups.Results Postoperative follow-up time≥6 months.There was no significant difference in fluoroscopy times and fracture healing time between the two groups(P＞0.05).The operation time,full weight-bearing time and intraoperative blood loss in the intramedullary nail group were significantly less than those in the plate group(P＜0.05).At 24 h and 72 h after operation,C-reactive protein and interleukin-1β in the intramedullary nail group were significantly lower than those in the plate group(P＜0.05).At 3 months after operation,the VAS of the intramedullary nail group was significantly lower than that of the plate group(P＜0.05),and the AOFAS score was significantly higher than that of the plate group(P＜0.05).At 6 months after operation,there was no significant difference in AOFAS score between the two groups(P＞0.05).At the last follow-up,the excellent and good rate of fracture reduction in the intramedullary nail group was 100％,and that in the plate group was 97.83％,there was no significant difference between the two groups(P＞0.05).The incidence of complications was 7.84％in the intramedullary nail group and 13.73％in the plate group,there was no significant difference between the two groups(P＞0.05).Conclusion Both RTN and MIPPO have satisfactory efficacy and safety in optimizing the surgical process,reducing intraoperative blood loss,shortening the full weight-bearing time,alleviating early postoperative pain,and improving ankle joint function.