Therapeutic Analysis Of Bone Defect And Soft Tissue Defect After Open Tibial Fracture With The Theory Of Paying Equal Attention To Sinew And Bone

Objective:To compare the clinical efficacy of Ilizarov external fixator with Orthofix external fixator in the treatment of bone defect and soft tissue defect after open tibial fracture,with the guiding theory of "Paying Equal Attention to Sinew and Bone" in traditional Chinese medicine and the treatment method of bone shortening and lengthening.And its purpose is to provide reference for the choice of clinical treatmentMethods:Retrospective analysis was performed on 40 cases of patients with bone defect and soft tissue defect after open tibial fracture admitted to 960th hospital of the PLA from September 2014 to September 2019.All the patients were treated by Ilizarov bone shortening and lengthening.According to the differences in surgical methods,the Ilizarov external fixator group(group A)and the Orthofix external fixator group(group B)were divided into each group with 20 cases.Recording and evaluating the clinical data of two groups of cases,bone defect length,soft tissue defect in the area,operation time,intraoperative blood loss,bone healing time,the main complications after operation,HHS of knee joint function after surgery for grading,Baird-Jackson of ankle joint function after surgery for grading.SPSS25.0 statistical software was used to conduct t test,X2 test analysis of recorded patient data in the two groups in this study.Results:All 40 patients were reviewed and followed up with no adverse events.The results showed that there were statistically significant differences in operative time,intraoperative blood loss,major postoperative complications and postoperative ankle function between the two groups.The mean operation time of group A was 147.95±18.59min,and that of group B was 115.75±10.97min.There was A statistical difference between the two groups(P<0.05).The operation time of group B was shorter than that of group A.The average intraoperative blood loss in group A was 155.60±20.79ml,and that in group B was 102.25±26.73ml.There was A statistical difference between the two groups(P<0.05),and the intraoperative blood loss in group B was less than that in group A.There were 6 patients with ptosis in group A and 1 patient in group B,and the difference was statistically significant(P<0.05).The incidence of ptosis in group A was higher than that in group B.Two patients with bone migration in group A and eight patients with bone migration in group B had statistically significant differences(P<0.05).The incidence of bone migration in group B was higher than that in group A.The mean postoperative ankle function score of group A was 78.95±7.27 points,and that of group B was 85.50±6.04 points.There was A statistical difference between the two groups(P<0.05).The postoperative ankle function of group B was better than that of group A.Conclusion:In the treatment of bone defect and soft tissue defect after open tibial fracture with bone breach-lengthening surgery,the use of Orthofix external fixation stent surgery time is short,intraoperative blood loss is small,postoperative podioptosis is less likely to occur,postoperative ankle joint function is good.Ilizarov external fixator has a low probability of bone migration,and it is firm and stable.Therefore,it is necessary to choose the treatment plan according to the advantages of the two treatment methods and the specific situation of the patients.