| Objective:To observe the based on the theory of "bone setting eight methods" under the guidance of conservative treatment,open reduction bridge combined fixation and anatomic locking plate internal fixation for the treatment of the clinical efficacy of adult limbs fracture,summarizing bridge combined internal fixation system in the treatment of adult limbs fracture aspects of advantages and disadvantages,and proposes the improved design scheme on the basis of the original structure,the bio-mechanical test,for the bridge combined fixation system to provide the reference for the performance improvement suggestions.Methods:Retrospective analysis was performed on adult limb fracture patients admitted to the Department of Orthopaedics,Yangzhou Affiliated Hospital of Nanjing University of Chinese Medicine from January 2016 to August 2018.According to the inclusion and exclusion criteria,a total of 104 patients were selected for this study.According to treatment into conservative groups,bridge and locking plate group,conservative group of 28 cases of clavicle fracture patients,using "bone setting eight method" gimmick reset after the bandage fixation for"8" word,bridge group of 38 patients(28 cases of clavicular fracture,10 cases of limbs fracture)based on "bonesetting eight law" under the guidance of the theory of bridge combined surgery fixation system,locking plate group 38 cases(28 cases of clavicular fracture,10 cases of limbs fracture)patients according to the specific use of anatomic locking plate for the surgical treatment of fractures is.The fracture healing time,functional score and complication rate of the three groups were compared to evaluate the clinical efficacy,and the surgical indicators of the bridging group and the locking plate group were compared to evaluate the advantages and disadvantages of the two internal fixation methods.The polyformaldehyde fracture model was used as the limit test and destructive test object to test the difference between the compression and rotation resistance of the bridge internal fixation 1.0(circular bamboo band),the bridge internal fixation 2.0(hexagonal groove band),the bridge internal fixation 3.0(hexagonal groove band)and the anatomical locking plate.Results:(1)There was no significant difference in baseline data before treatment among the three groups(P>0.05).(2)Compared with the conservative group,the fracture healing time of the bridging group and the locking plate group was significantly shortened(P<0.05).According to the shoulder Constant score standard,1 month,3 months and 12 months after treatment were all higher in the three groups than before treatment(P<0.05),but there was no significant difference in the shoulder Constant score in the three groups at 12 months after treatment(P>0.05).(3)Compared with the locking plate group,the bridge group had a shorter operative time(P<0.05)and there was no difference on intraoperative blood loss per minute(P>0.05).(4)Postoperative complications:1 patient in both the conservative group and the bridging group had nonunion,and 1 patient in the locking plate group had re-fracture of the fracture site after removal of internal fixation.(5)In the polyformaldehyde fracture model,the compression and rotation resistance of the bridged internal fixation 2.0(six-sided bamboo bar)is stronger than that of the bridged internal fixation 1.0(round bamboo bar).The compression and rotation resistance of the bridge internal fixation 3.0(hexagonal groove bar)is stronger than that of the bridge internal fixation 2.0(six-sided bamboo bar).The compression and rotation resistance of the bridge internal fixation 3.0(hexagonal groove bar)is stronger than that of the bridge internal fixation 1.0(circular bamboo-like bar).The compression and rotation resistance of the anatomical locking plate is better than that of the bridged internal fixation 1.0(circular bamboo bar),bridged internal fixation 2.0(hexagonal bamboo bar)and bridged internal fixation 3.0(hexagonal groove bar).Conclusion:Based on the theory of "bone setting eight method" under the guidance of conservative treatment,open reduction bridge combined fixation and anatomic locking plate internal fixation for the treatment of adult treatment clavicular fracture,but based on the theory of "bone setting eight method" under the guidance of bridge combined fixation system have more advantages,has the characteristics of rapid recovery,fewer complications,and can reduce the occurrence of internal fixation fracture,osteoporosis,internal fixation was removed under stress,and then the risk of fractures,a new type of extremities fractures can be treated as adults within the fixed way that is worth wide use in the orthopedic surgeon.In the polyformaldehyde fracture model,the compression and rotation resistance of the bridged internal fixation 2.0(six-sided bamboo bar)and the bridged internal fixation 3.0(hexagonal groove bar)are better than that of the bridged internal fixation 1.0(circular bamboo bar),which can be used as a reference for further improving the design of the combined internal fixation system in the future. |
