Orthopedic & Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro" - AOU Consorziale "Policlinico", Piazza Giulio Cesare 11, 70100 Bari, Italy.
Orthopedic & Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro" - AOU Consorziale "Policlinico", Piazza Giulio Cesare 11, 70100 Bari, Italy.
Injury. 2020 Aug;51 Suppl 3:S80-S85. doi: 10.1016/j.injury.2020.02.042. Epub 2020 Feb 12.
In recent years, Minimally Invasive Plate Osteosynthesis (MIPO) has been gaining popularity in the treatment of distal tibia fractures, because it is a minimally invasive surgical procedure, thus it limits the soft-tissues damage. This prospective randomized study aims to assess the impact of lag screw in the healing time of distal tibia fractures treated with MIPO technique, in a six-month follow-up.
Patients between 20 and 70 years of age with distal tibial fracture, type 43-A according to AO/OTA classification system were included. All the patients were randomized into two groups, to receive MIPO without lag screw (Group-A) or MIPO with percutaneous lag screw (Group-B). Patients were followed clinically and radiographically at 3, 6, 12 and 24 weeks postoperatively. The main outcome measure was the time needed to achieve the painless full weight-bearing (FWB) after surgery. Unpaired t-test after ANOVA (analysis of variance) was performed to assess AOFAS score differences between the 2 groups at each follow-up. Pearson correlation test also was performed. The tests were two-tailed with a confidence level of 5%.
42 patients (24 male and 18 female, mean age 49.54 years old, range 25-80) were recruited. A significant shorter mean time until painless FWB (p = 0.016) was observed in Group-B (11.22 ± 3.06 weeks) compared with Group-A (13.48 ± 2.42 weeks) (Table 2). The mean AOFAS score was comparable in patients treated with (Group-B) and without lag screw (Group-A) at all follow-ups.
This prospective randomized clinical study has shown that the use of lag screw in distal tibia fractures treated with MIPO technique speeds the fracture healing, thus shortening the time needed to achieve FWB.
近年来，微创钢板接骨术（MIPO）在治疗胫骨远端骨折方面越来越受欢迎，因为它是一种微创手术，因此限制了软组织的损伤。本前瞻性随机研究旨在评估在 6 个月的随访中，拉力螺钉对 MIPO 技术治疗胫骨远端骨折愈合时间的影响。
纳入年龄在 20 至 70 岁之间、AO/OTA 分类系统为 43-A 型的胫骨远端骨折患者。所有患者均随机分为两组，一组接受无拉力螺钉的 MIPO（A 组），另一组接受经皮拉力螺钉的 MIPO（B 组）。患者在术后 3、6、12 和 24 周进行临床和影像学随访。主要观察指标为术后达到无痛完全负重（FWB）所需的时间。采用方差分析（ANOVA）后进行单样本 t 检验，以评估两组在每个随访时间点 AOFAS 评分的差异。还进行了 Pearson 相关性检验。检验为双侧检验，置信水平为 5%。
共纳入 42 例患者（24 例男性，18 例女性；平均年龄 49.54 岁，范围 25-80 岁）。B 组（11.22±3.06 周）达到无痛 FWB 的平均时间明显短于 A 组（13.48±2.42 周）（p=0.016）（表 2）。在所有随访中，接受和未接受拉力螺钉治疗的患者的 AOFAS 评分均相似。
本前瞻性随机临床研究表明，在 MIPO 技术治疗胫骨远端骨折中使用拉力螺钉可加速骨折愈合，从而缩短达到 FWB 所需的时间。
