Therapeutic effects of early and delayed minimally invasive percutaneous plate osteosynthesis surgery on distal tibial metaphyseal comminuted fracture

This study aims to investigate the effect of early and delayed injury minimally invasive percutaneous plate osteosynthesis on the treatment of distal tibial metaphyseal comminuted fracture. This study involved 90 patients with distal tibial metaphyseal comminuted fractures for treatment of minimally invasive percutaneous plate osteosynthesis between February 2012 and October 2014 in our hospital. According to treatment time, 90 patients were divided into early group and delayed group. Early group performed minimally invasive percutaneous plate osteosynthesis (MIPPO) surgery in early injury, delayed group performed MIPPO surgery in delayed injury. There were no differences for operation time, intra-operative bleeding, follow-up time and fracture healing time between early and delayed groups (P>0.05). Hospitalization time in early group (14.3±2.4 d) was significantly shorter than delayed group (19.7±3.3 d) (t=8.878, P<0.05). There were no claudication, fixation failure, nonunion and other complications in two group patients. In last follow-up, there were no significant differences for Lowa ankle score of function, pain, gait, activity between two groups (P>0.05). There were no significant differences for Lowa ankle rating score between early and delayed group (t=0.636, P>0.05). Soft tissue complications incidence after surgery of two groups were 4.44% and 8.89% respectively, the differences were not statistically significant (χ2=0.714, P>0.05). In conclusion, effect of early and delayed injury minimally invasive percutaneous plate osteosynthesis for treatment of distal tibial metaphyseal comminuted fracture and postoperative complications incidence of soft tissue were comparable. Hospitalization time was shorter for early injury treated with minimally invasive percutaneous plate osteosynthesis.