Abstract：
BACKGROUND: Indirect reduction of minimally invasive plate osteosynthesis (MIPO) can often result in delayed union in tibia fractures. This study evaluated several factors in MIPO in relation to bone union.
OBJECTIVE: We hypothesized that the fracture gap, plate - tibia distance, or working length would have a substantial effect on the tibia union rate.
METHODS: Forty-one patients with simple diaphyseal or distal metaphyseal tibia fractures who underwent internal fixation surgery using the MIPO technique were divided into two groups: patients with delayed union and patients without delayed union. Non-actionable factors involving AO/OTA classification, fibula fracture and actionable factors including postoperative fracture gap, plate - tibia distance, working length in relation to parameters of bone union were compared between the two groups. Also cumulative rates of bone union and risk factors of delayed union according to variables of interest were investigated.
RESULTS: AO/OTA classification, site of fibula fracture, postoperative fracture gap, working length, and bone union rate of the two groups significantly differed (p<0.05). The cumulative rate of bone union during 1-year follow-up according to 43A tibia fracture, distal fibula fracture, fracture gap, and working length significantly differed between the two groups (p<0.05). By univariate Cox proportional hazards model, 43A tibia fracture, distal fibula fracture, facture gap, and short working length were risk factors for delayed union (p<0.05).
CONCLUSIONS: Non-actionable factors involving AO/OTA classification, distal fibula fracture and actionable factors including postoperative fracture gap, working length were significant factors affecting bone union after MIPO. The present study indicated that small fracture gap and long working length during MIPO might facilitate bone healing in tibia fracture.
METHODS: IV; single-center retrospective cohort study.
OBJECTIVE: We hypothesized that the fracture gap, plate - tibia distance, or working length would have a substantial effect on the tibia union rate.
METHODS: Forty-one patients with simple diaphyseal or distal metaphyseal tibia fractures who underwent internal fixation surgery using the MIPO technique were divided into two groups: patients with delayed union and patients without delayed union. Non-actionable factors involving AO/OTA classification, fibula fracture and actionable factors including postoperative fracture gap, plate - tibia distance, working length in relation to parameters of bone union were compared between the two groups. Also cumulative rates of bone union and risk factors of delayed union according to variables of interest were investigated.
RESULTS: AO/OTA classification, site of fibula fracture, postoperative fracture gap, working length, and bone union rate of the two groups significantly differed (p<0.05). The cumulative rate of bone union during 1-year follow-up according to 43A tibia fracture, distal fibula fracture, fracture gap, and working length significantly differed between the two groups (p<0.05). By univariate Cox proportional hazards model, 43A tibia fracture, distal fibula fracture, facture gap, and short working length were risk factors for delayed union (p<0.05).
CONCLUSIONS: Non-actionable factors involving AO/OTA classification, distal fibula fracture and actionable factors including postoperative fracture gap, working length were significant factors affecting bone union after MIPO. The present study indicated that small fracture gap and long working length during MIPO might facilitate bone healing in tibia fracture.
METHODS: IV; single-center retrospective cohort study.
摘要：
背景：间接复位微创钢板接骨术（MIPO）通常会导致胫骨骨折延迟愈合。这项研究评估了MIPO中与骨愈合有关的几个因素。
目的：我们假设骨折间隙，钢板-胫骨距离,或工作长度会对胫骨结合率产生重大影响。
方法：41例使用MIPO技术进行内固定手术的单纯性干骨干或胫骨远端干骨干端骨折患者分为两组：延迟愈合患者和无延迟愈合患者。涉及AO/OTA分类的不可操作因素，腓骨骨折和可行因素，包括术后骨折间隙，钢板-胫骨距离,比较两组间工作长度与骨愈合参数的关系。根据感兴趣的变量，还研究了骨愈合的累积率和延迟愈合的危险因素。
结果：AO/OTA分类，腓骨骨折部位,术后骨折间隙,工作长度,两组骨愈合率差异有统计学意义(P<0.05)。根据43A胫骨骨折随访1年的骨愈合累积率，腓骨远端骨折,断裂间隙,两组间工作时长差异有统计学意义(P<0.05)。通过单变量Cox比例风险模型，43A胫骨骨折,腓骨远端骨折,制造间隙,工作时间短是延迟愈合的危险因素(P<0.05)。
结论：涉及AO/OTA分类的不可操作因素，腓骨远端骨折和可操作因素，包括术后骨折间隙，工作长度是影响MIPO术后骨愈合的重要因素。目前的研究表明，在MIPO过程中，小的骨折间隙和长的工作长度可能有助于胫骨骨折的骨愈合。
方法：IV；单中心回顾性队列研究。
目的：我们假设骨折间隙，钢板-胫骨距离,或工作长度会对胫骨结合率产生重大影响。
方法：41例使用MIPO技术进行内固定手术的单纯性干骨干或胫骨远端干骨干端骨折患者分为两组：延迟愈合患者和无延迟愈合患者。涉及AO/OTA分类的不可操作因素，腓骨骨折和可行因素，包括术后骨折间隙，钢板-胫骨距离,比较两组间工作长度与骨愈合参数的关系。根据感兴趣的变量，还研究了骨愈合的累积率和延迟愈合的危险因素。
结果：AO/OTA分类，腓骨骨折部位,术后骨折间隙,工作长度,两组骨愈合率差异有统计学意义(P<0.05)。根据43A胫骨骨折随访1年的骨愈合累积率，腓骨远端骨折,断裂间隙,两组间工作时长差异有统计学意义(P<0.05)。通过单变量Cox比例风险模型，43A胫骨骨折,腓骨远端骨折,制造间隙,工作时间短是延迟愈合的危险因素(P<0.05)。
结论：涉及AO/OTA分类的不可操作因素，腓骨远端骨折和可操作因素，包括术后骨折间隙，工作长度是影响MIPO术后骨愈合的重要因素。目前的研究表明，在MIPO过程中，小的骨折间隙和长的工作长度可能有助于胫骨骨折的骨愈合。
方法：IV；单中心回顾性队列研究。
