Boxin Wang, Can Wu*, Zenggang Chen, Jingshu Fu, Renggang Shi


Banan District People's Hospital of Chongqing, Chongqing, 401320, China


Introduction: To investigate the clinical effect of percutaneous locking plate system assisted interlocking intramedullary nail in the treatment of multiple tibial fractures include proximal fractures.

Materials and methods: From January 2016 to December 2019, 16 cases of multi segment tibial fractures with proximal fractures were selected, including 10 males and 6 females, aged 20~68 years, who were treated with percutaneous locking plate system assisted by tibial interlocking intramedullary nail. 9 cases of them were injured by traffic accident, 3 cases were injured by heavy pound, and 3 cases were injured by falling down;12 cases were closed fractures and 4 cases were open fractures. The patients were followed up from 14 months to 30 months after operation. X-rays were reexamined to understand the fracture healing and kolment and Wulff methods were used to evaluate the knee function after internal fixation.

Results: The average operation time of 16 patients was 98 (76~132) min. The average fracture healing time after operation was 30 (26~40) weeks. All fractures healed. There were no complications such as fracture nonunion, infection, and vascular and nerve injury. The knee joint function was excellent 3 months~ after operation.

Conclusion: The medullary cavity of the upper tibial fracture is large, and the simple interlocking intramedullary nail fixation will lead to complications such as displacement, delayed fracture healing and internal fixation failure. The percutaneous locking plate and screw system assisted by the tibial interlocking intramedullary nail can achieve satisfactory reduction and firm fixation, allow early postoperative functional exercise, and achieve good curative effect. 


Comminuted fracture of tibia, interlocking intramedullary nail, percutaneous locking plate screw system.