Comparison Of Two Internal Fixed Methods For Closed Distal Tibial Fractures

Objective:Comparative summary of anatomical lateral distal tibial plate with two kinds of clover plate fixation for the treatment of closed distal tibial fracture clinical efficacy of grass-roots hospitals for clinical treatment of closed distal tibial fracture fixation provide the basis for selection.Methods:A retrospective survey was analyed in our hospital from 1999.5-2008.5.A total of 85 cases of closed distal tibial fracture were followed.43 cases of which were fixed by the lateral distal tibial anatomy plate and 42 cases of which were fixed by clover grass plate.The clinical effects were analyed and compared by operative time and fracture healing time.Ovadia efficacy assessed using symptoms and ankle function scoring system.T test and X~2 test were used for statistical analysis.P＜0.05 was considered significant difference.Results:All patients were followed up for 6 months to 96 months,an average of 48 months.Anatomical lateral distal tibial plate fixation group:operation time were 50 minutes～90 minutes,an average of 65 minutes;The average healing time of fracture were 4 months to 9 months,an average of 6.5 months,of which three cases of delayed healing,zero patients on plate fracture occurred.The group of 32 cases of excellent,good in six cases,four cases can be,and poor in one case.Excellent rate is 88.37%.Two cases of wound dehiscence,wound infection in two cases of bone,one cases of delayed union fractures.Clover plate fixation group:operation time 60～100 minutes,an average of 70 minutes;The average healing time of fracture for 4.5 months to 10 months,an average of 6.5 months,the group of 26 cases of excellent, good in six cases,six cases could be,and poor in four cases.Excellent rate is 76.19%. Those of which four cases of wound dehiscence,wound infection in four cases,two cases of delayed union of fractures,the two cases of saphenous vein injury.There was no significant difference between operating time and bone healing time for two groups.However,the incidence of complications of clover plate group was higher than that of the lateral distal tibial anatomical plate group.The excellent and good rate of postoperative lateral distal tibial anatomical plate group was higher than clover plate group and there was significant difference.Conclusion:The distal tibial anatomical plate in the treatment of closed distal tibial fracture was more effective than clover plate group,with less complications and good functional recovery of ankle was obtained,and affordable for the majority of grass-roots hospitals.