Clinical Study Of Stress Stimulation Combined With Powder Of Seven-Li For Bone-knitting To Treatment Of Comminuted Fractures Of The Lower Extremity Shaft

Objective:To evaluate the clinical efficacy and practical valus of combined bown growth regulation induced by stress stimulate and powder of seven-li for bone-knitting (PO SL FBK) in the treatment of postoperative of comminuted lower extremity shaft fractures.Methods:A prospective clinical study was conducted between February2010to February2011. A total of120comminuted lower extremity shaft fractures received open reduction and internal fixation were enrolled in this study. The patients were randomly divided into three groups accoding to their admission sequence:TCM group (treated by traditional Chinese medicine) ROS group (treated by rap system of bone stress stimulator) and Combined group (treated by traditional Chinese medicine combined with rap system of bone stress stimulator), Each contained40cases. The TCM group were given oral PO SL FBK1.5g/bid immediately after the surgery.The ROS group began to received rap treatment1week postoperative30min/bid with8hours interval. The stress frequency was sent at0.5HZ, while strength was set200N for tibial fracture and250N for femur fracture. The combined group added TCM treatment on the basis of the rap system of bone stress stimulator treatment.Clinical assessments including visual analogue scale, VAS for pain、the degree of limb swelling and weight bearing status of the affected leg were conducted at1week,3months6months and12months after the surgery. Callus growth and fracture healing was evaluated radiographically at3,6and12months.Fracture healing time and delayed union rate at6months or non-union rate at12months was recorede.Results:All the patients were followed and mean follow-up time was13.5months (range12-16months). None of the patients had complications during treatment The TCM group and Combined group had significant better pain release and limb swelling reduce than ROS group (P<0.017), while TCM group and Combined group had no statistical differences (P>0.05). The clinical healing time, the growth of the callus, limb weight, delayed union rate and non-union rate in ROS group and Combined group were significantly better than TCM group at all time points (P<0.017), while the grade of callus grade、limb weight bearing and the clinical healing time of Combined group were superior to ROS group at3and6months (P0.017).Conclution:Application of Rap system of bone stress stimulator oral had better effect on promoting lower extremity shaft fracture healing than oral PO SL FBK intake alone, which accelerating the growth of callus and shortening bone healing time while preventing and reducing bone delayed union and non-union at the same time. Combined with Powder of Seven-Li for Bone-knitting adjuvant therapy, limb swelling and postoperative pain is effectively reduced, which guarantee early postoperative functional exercises, thus promote the healing of fracture together with stress stimulator. It also had better clinical effect than applying simple rap system of bone stress stimulator alone. As a results, combination therapy can be used rountinely as a adjuvant treatments for comminuted lower extremity shaft fractures after internal fixation.