A Rangdomized Controlled Study Of Unilateral Or Bilateral Incision’s Operation And Interal Fixation Combined With Huoxue Zhitong Tang Treat Fracture Of Tibilfibula Middle And Lower Section

ObjectiveTo discuss the clinical effect of different incision open reduction and plate internal fixation treating tibiofibula middle section of the double fracture,evaluate the effect of huoxue zhitong tang with it,which can be applied in the treatment of tibiofibula middle section of a double fracture, and provide a reference for future clinical.MethodChoose patients accepting surgery treatment of tibiofibula middle segment of double fracture between December2010to June2012in fuzhou general hospital of nanjing military region, according to the stochastic indicator method,120patients were divided into control group (group A) and treatment group (group B), the control group (group A)56cases, treatment group64cases (group B). Finally included in the statistical analysis of patients in the control group (group A)52cases and the treatment group (group B)60cases.64cases of male, female48cases, aged20to81years old, average50.5±6.34years old. Injury types: traffic accident injury of53cases, high falling injury32cases, by heavy parts27cases. Open fractures43cases (Gustilo Ⅰ type21cases, Ⅱ16cases, Ⅲ type A6),69cases of closed fractures. All cases adept operative treatment within24hours after the injury. Control group (group A) inside and outside double leg incision open reduction and plate fixation, with fracture as the center, take the tibia in the trailing edge longitudinal incision exposed tibia, choosing the right plate fixation; External ankle and fibular head connection, do longitudinal incision exposure for the center with fibular fracture fibula, choose appropriate plate fixation of fibula. Treatment group (group B) on crus anterolateral incision open reduction and plate fixation:calf anterolateral incision, according to the location of the fracture, incision design into "S" shape cut the skin and subcutaneous tissue, at the same time exposed tibia and fibula fracture end, reduction and plate fixation to choose the appropriate after fracture. Two groups of patients with postoperative used routinely to prevent infection and promote fracture healing drugs such as symptomatic treatment, at the same time, according to the principle of early damage of evidence-based medicine of traditional Chinese medicine, bone fracture early due to qi and blood stasis, acetanilide detumescence, with promoting blood circulation to remove blood stasis, blood circulation by removing blood stasis, Give oral promoting blood circulation to remove blood stasis, qi analgesic representative party huoxue zhitong tang.Postoperative follow-up of3to18months, compare A/B two groups of patients with operation time, blood loss, callus occurrence time, incision healing time, complications, fracture healing time, and within the groups A, B two groups of patients more swelling to relieve pain relief.Result1. The baseline to compareTwo groups of patients’demographic data (age, gender) and fracture type, p>0.05, no statistical significance; Two groups of baseline, comparable.2. The efficacy of huoxue zhitong tangTreatment group and control group two groups of patients, respectively is swelling, alleviate pain relief and degree index in the group, P<0.05, the difference was statistically significant. Application shows that Huoxue zhitong tang relieve swelling and pain in the early fracture effect is obvious.3. The comparison between groupsTwo groups of operation time and blood loss in patients with comparison, P<0.05, the difference was statistically significant.Two groups of patients with bone callus appeared time, incision healing time, complications situation comparison, P<0.05, the difference was statistically significant.Two groups of patients with fracture healing of Johner-Wruh score comparison, P<0.05, the difference was statistically significant.Through comparison between groups, open reduction and plate fixation is bilateral unilateral incision incision open reduction and plate fixation in operation time, blood loss, bone callus appeared time, incision healing time, complications occurrence has obvious advantages, and can effectively shorten fracture healing time.Conclusion1. Calf single anterior lateral incision open reduction and plate internal fixation, compared with traditional surgery, can significantly shorten the operation time, less blood loss, Reduce the happening of the complications such as postoperative infection, bone plate exposed,and indirectly promote the healing of fracture.2. The dialectical treatment effect Huoxue zhitong tang is obvious, in the early fracture combined with anterior lateral crus tibiofibula fractures treated by single incision is effective method, can be carried out in clinical widely.