| Objective:For the patients of the shaft fractures of lower extremity result from acute high-energy injuries, early postoperative intervented and treated with rap system of bone stress stimulator, to explore the clinical effect and value of application of rap system of bone stress stimulator on promoting of the shaft fracture healing of the lower extremity.Methods:Between January 2009 and July 2010, a total of 92 case of shaft fractures of the lower extremity hospitalization patients received open reduction and internal fixation or external fixation were enrolled in this study. The classification of femoral shaft fractures accorded Winpuist-Hansen, tibial shaft fractures accorded Johner-Wruhs and open fractures accorded Gustilo. Postoperative patients were randomly divided into two groups with 46 patients in the study group who received rap system of bone stress stimulator and 46 patients in the control group.Patient in the study group received rap treatment for heel to provide stress stimulation to fracture ends in early postoperative. Each patient treated with stress frequency 0.5Hz, for each tibial fracture with external fixator fixation treated with 150N, plate and intra-medullary nailing fixation treated with 200N,each femur fracture with external fixator fixation treated with 200N, plate and intramedullary nail fixation treated with 250N. Two times rap treatment everyday,30 minutes every time and the interval time was 8 hours. Patients in the control group did not receive treatment with rap system of bone stress stimulator postperative. The evaluation parameters included clinical assessments of pain score (visual analogue scale, VAS) and weight bearing status of the affected leg, recorded the healing time, and serial rad-iographs assessments for callus formation and fracture healing at 3,6 and 12 months. The pri-mary end point is the rate of non-union at 12 months, and the secondary end point is the rate of delayed union at 6 months.Results:Patients were followed up an average of 13.6±2.4 months (range from 12-18months) There were two patients lost follow-up (all at 12 months) in the study group and two patients (one at 6 months, one at 12 months) in the control group.There were no deicerelated problem, no systemic or local complications directly related to rap system of bone stress stimulator. The study group showd significantly better VAS score and weight bearing status on the affected leg than the control group at 3,6 and 12 months(P<0.05). The healing time were 88.78±8.80 d in the study group compared with 107.91±9.03d in the control group, there were significantly statistical differences between the two groups (P<0.01). The callus formation was signifi-cantly faster and better in the study group as compared with the control group at each of the time intervals at 3,6 and 12 months(P<0.05). At 12 and 6 months follow-up, the rate of non-union and delayed union was4.6% (2 cases),13.6% (6 cases)for the study group verus 15.9% (7 cases),36.4%(16 cases)for the control group,and the difference was statistically significant between the two groups (P<0.05).Conclution:Rap system of bone stress stimulator is effective on promoting and accelerating fracture healing, obviously shorting the time of fracture healing, preventing and decreasing bone delayed union and non-union in acute high-energy shaft fractures of the lower extremity. It has security, non-invasive, effective and economic characteristics on promoting fracture healing, and can be used as a conventional complementary treatments for shaft fractures with internal fixation of the lower extremity, has good clinical application value. |
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