| Objective To understand the age distribution, gender distribution, injury causes distribution, injury parts distribution of the in-patients at the Department of Orthopaedics for accidental injury, and focus on understanding the injury causes and the injury properties of elder people above the age of 60. To take the tibial fracture cases in accidental injuries as the research object, and compare the clinical effect of the two operation plans: the closed reduction and interlocking intramedullary nailing and the percutaneous minimally invasive locking compression plate. Methods Perform the statistics and analysis for the first page of the medical records and the leaving hospital record data of the in-patients at the Department of Orthopaedics for accidental injury, from a secondary hospital which undertakes the first-aid (120) task of the whole Mingguang city, the period of the data is from 2007.05 to 2009.04. The selecting standard is the traumatic case caused by accidental injury, the patient who comes to the hospital again to remove the internal fixation for the same traumatic reason should be excluded, and the traumatic case caused by self-injury also should be excluded. Input all materials into the computer and perform the statistics and analysis by using Microsoft Office Excel. At the same time, 73 cases of tibial fracture patients caused by accidental injury treated at the Department of Orthopaedics of a hospital from 2007.05 to 2009.12 are retrospectively analyzed, according to the operation types the cases are divided into two groups, and the two groups are compared and viewed for the operation time, the perspective times, the formation time of the callus, the clinical cicatrization time, the osseous cicatrization time, the incidence rate of the operative complications, Johner-Wruhs function evaluation results and hospitalization charges. Results The numbers of the traumatic cases are 79.0% of all the accidental injury cases in the corresponding period, the numbers of the male patients are 2.12 times of the female patients, for the age distribution, the age group of 40-49 has the largest population, and for the time distribution, there are two small peaks in the all day long research, which respectively are 8:00 in the morning (5.4%) and 9:00 at night (5.8%). The top three causes of the accidental injury are: road accident injury (43.4%), drifting-down injury (31.7%) and the bruise injury caused by heavy object (12.8%). Most injury parts are the lower limbs which often have fractures, the incidence rate of the multiple fracture is 1.0%, 2.5% of the cases are coming with other visceral organs injury, 1.0% cases are coming with shock, and 1.2% cases are coming with spinal cord injury. For the elder people above 60, the commonly see injury is the fracture of hip, the incidence rate is 39.6%, and the causes for accidental injury of elder people above 60 are the same as all peoples. In 73 cases, the tibial fracture cases all gain osseous cicatrization. For the operation time, the perspective times, the formation time of the callus, the clinical cicatrization time, the osseous cicatrization time, the overall incidence rate after the operation and Johner-Wruhs function evaluation results of the two groups, the comparison differences have no statistical significance (P>0.05).The hospitalization charges have obvious differences. Conclusions Most in-patients at the Department of Orthopaedics are young adults, the first injury cause is road accident, and the condition of the injury is complicated, with various combined injures and multiple injuries. In the accidental injures of the elder peoples above 60, the fracture of the hip has the highest incidence rate. The general public shall know the precaution knowledge and the basic technologies, and at the same time, the relevant hazards shall be reduced. The closed reduction and interlocking intramedullary nailing technology and the locking compression plate through bridging technology are all good methods for treating the tibial fracture, and the interlocking intramedullary nailing technology is suitable for the middle tibia fracture including comminuted fracture and complex fracture. LCP is suitable for the fracture of each section, and especially the locking compression plate is more suitable for the near end fracture and the far end intumescence part fracture, or the patient with serious osteoporosis. The percutaneous minimally invasive locking compression plate technology has obvious advantages, and the incidence rate of the arthralgia after the operation is reduced. The hospitalization charge for the interlocking intramedullary nailing is lower, which is more suitable for the basic hospitals. |
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