Efficacy Analysis Of Locking Plate And Reamed Intramedullary Nail For Tibial Nonunion

Objective:Retrospectively analyze the efficacy of reamed intramedullary nail and locking plate for tibial aseptic nonunion, then evaluate the therapeutic effect of the two methods to explore the treatment of tibial aseptic nonunion.Methods:From October2009to August2011, we had treated45cases of tibial aseptic nonunion with39of followed up. The ages of the39followed-up cases were among24to65, averagely39.5, and29of then were male when10of them were female.9of them were atrophic nonunion nine cases and30of them were hypertrophic ones. Their time intervals from initial surgery to surgery treatment are among12-60months, averagely29.3months. Among the39cases,27were initially treated with plate,7with intramedullary nail and five with external fixator. We fixed21cases with locking plate and18cases with reamed intramedullary nail, which we respectively defined of the Locking Plate Group and the Intramedullary Nail Group. Each case was reviewed respectively1,3,6,12months after surgery. The cases were compared between the two groups in operative time, callus score of postoperative3months and6months, healing time, and the knee and the ankle function score6months after surgery. Lastly, all the data was statistically analyzed with SPSS software.Results:All the39patients were followed-up for6-18months, an average of10months.1, the average operative time of locking plate group (125±15.38min) is longer than that of intramedullary nail group (110±16.40min)(p<0.05);2, the clinical average healing time was no significant difference (p>0.05);3,3months after surgery, the callus growth score of locking plate group was higher than reamed intramedullary nail group (p<0.05);4, six months after surgery, the function score of knee and ankle of the two groups were significantly improved (p<0.05), but there aren’t significant differences in function scores of Knees and ankles between the two groups (p>0.05).Conclusion:1, Locking plate and reamed intramedullary nailing are both effective for treating tibial nonunion, which have high curing rates, and both are good choices for the treatment of tibial aseptic nonunion.2,The two methods have their own advantages, clinicians should take the non-healing types and the initial fixed types of the patients into consideration and choose the most appropriate internal fixation for each case.