title: [Comparison study on two operations for treatment of extra-articular distal tibial fracture].
abstract: OBJECTIVE
  To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) for treatment of extra-articular distal tibial fracture.
  
  
  METHODS
  Between March 2009 and March 2012, 57 patients with extra-articular distal tibial fractures were treated, and the clinical data were retrospectively analyzed. Of 57 cases, 31 were treated with MIPO (MIPO group), and 26 with ORIF (ORIF group). There was no significant difference in gender, age, cause of injury, type of fractures, complication, and time from injury to operation between 2 groups (P > 0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were compared between 2 groups.
  
  
  RESULTS
  There was no significant difference in operation time and intraoperative blood loss between 2 groups (P > 0.05). Wound infection occurred in 5 cases [2 in MIPO group (6.5%) and 3 in ORIF group (11.5%)] showing no significant difference (Chi(2)=0.651, P=0.499). The other wound obtained healing by first intention. All cases were followed up 13-24 months (mean, 15 months). No significant difference was found in the average healing time between 2 groups and between patients with types A and B by AO classification (P > 0.05); in patients with type C, the healing time in MIPO group was significantly shorter than that in ORIF group (t= -2.277, P=0.033). Delayed union was observed in 3 cases of MIPO group (9.7%) and in 4 cases of ORIF group (15.4%), showing no significant difference (Chi(2)=0.428, P=0.691). Mal-union occurred in 4 cases of MIPO group (12.9%) and in 1 case of ORIF group (3.8%), showing no significant difference (Chi(2)=1.449, P=0.362). No significant difference was found in Mazur score between 2 groups (t=0.480, P=0.633). The excellent and good rate was 93.5% in MIPO group (excellent in 24 cases, good in 5 cases, fair in 1 case, and poor in 1 case) and was 92.3% in ORIF group (excellent in 18 cases, good in 6 cases, and poor in 2 cases), and the difference was not significant (Z= -0.687, P=0.492).
  
  
  CONCLUSIONS
  Both MIPO and ORIF have good results in treating extra-articular distal tibial fractures. MIPO is superior to ORIF for treating complex and communited fractures.
authors: The Graduate College of Tianjin Medical University, Tianjin, 300200, P.R.China.
authors: Haotian
authors: H
authors: Qi
authors: The Graduate College of Tianjin Medical University, Tianjin, 300200, P.R.China.
authors: Weikang
authors: W
authors: Li
authors: The Graduate College of Tianjin Medical University, Tianjin, 300200, P.R.China.
authors: Yongjie
authors: Y
authors: Zhao
authors: Area III of Traumatic Orthopedic Department, Tianjin Hospital.
authors: Yinguang
authors: Y
authors: Zhang
authors: Area III of Traumatic Orthopedic Department, Tianjin Hospital.
authors: Zhaojie
authors: Z
authors: Liu
authors: Area III of Traumatic Orthopedic Department, Tianjin Hospital.
authors: Jian
authors: J
authors: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000473:pathology / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D016267:External Fixators; D005260:Female; D005360:Fibula / Q000293:injuries / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013978:Tibial Fractures / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome