Intramedullary Compared With Pith Of External Fixation Method And Curative Effect Analysis Of Femoral Shaft Fracture

Objective: Through researching three kinds of commonly used treatment of femoralfractures methods (closed reduction and interlocking intramedullary nail fixation，openreduction and interlocking intramedullary nail fixation and LCP internal fixation)， thepaper analyzes the advantages And disadvantages of the three methods of the treatmentof femoral fractures，in order to provide better evidence for clinical treatment of femoralfractures fixation.Methods: Collecting120cases with femoral fracture patients treated at Yan Anuniversity affiliated hospital orthopedic ward from January2007to February2012， wedivided them into three groups (A， B， C)by random grouping. Group A chose closedreduction and interlocking intramedullary nail fixation (40cases)， group B chose openreduction and interlocking intramedullary nail fixation (40cases) and group C chose LCPinternal fixation (40cases). Record each patient’s operation time (from the beginning ofcutting the skin to the closing of the wound)， the loss of intraoperative blood， themobility of knee joint， complications(infection，bone nonunion or delayed union)， thetime of healing fracture， the recent and long-term knee function and comprehensivecurative effect. I evaluate the clinical value of three kinds of operation methods bystatisticResults: After1-2years of follow-up (mean time of13.55±13.55months)， theaverage intraoperative blood loss of group A was135.26±27.81ml， group B was412.53±26.45ml， group C was590.50±30.46ml. Tested by LSD-t，whenintraoperative blood loss of group A compared with group B And C， respectively， theresults are P <0.05， the difference are statistically significant， when intraoperative blood loss of group B compared with group C，the result is P <0.05， there isstatistically significant difference. Average surgery time of group A was133.67±15.77minutes， group B was174.83±18.86minutes， group C was174.63±174.63minutes，when compared the surgery time of group A with group B And C respectively， theresults are P <0.05， the difference are statistically significant， when compared surgerytime of group B with group C， the result is P>0.05， there is no statistically significantdifference. Average healing time of group A was115.2±5.5days， group B was137.2±8.7days，group C was136.9±7.8days，when compared the healing time of group Awith group B And C respectively the results are P <0.05， the difference are statisticallysignificant， when compared the healing time of group B with group C，the result isP>0.05，there is no statistically significant difference. After half a month knee jointactivity of group A was88.75±13.55°， group B was77.53±5.34°， group C was76.48±7.46°， when compared the knee joint activity of group A with group B Andgroup C， respectively， the results are P <0.05， the difference are statisticallysignificant， when compared the knee joint Activity of group B with group C，the resultis P>0.05，there is no statistically significant difference. After eight months， knee jointfunction assessment of group A was87.50%， group B was72.50%， group C was67.50%， when compared the knee joint function assessment of group A with group BAnd group C respectively by X2test， the results are P <0.05， the difference arestatistically significant， when compared the knee joint function assessment of group Bwith group C， by X2test，the result is P>0.05，there is no statistically significantdifference. After surgery, there was no complications in group A， in group B2caseswith internal fixation loosening occurs， so that cause bone nonunion， in group C onecases with internal fixation of fracture， one cases with internal fixation loosening， thetwo patients had occurred fracture healing; one case of delayed union. When comparedcomplications of group A with group B and group C respectively， the results are P <0.05， the difference are statistically significant. When compared complications of groupB with group C， the results is P>0.05， no statistical significance. A， B， C three groups had no postoperative infection.After8months clinical curative effectcomprehensive evaluation of group A was87.50%， B group was72.50%, group Cwas67.50%, when compared the clinical curative effect comprehensive evaluation ofgroup A with group B and group C， respectively， by X2test， the results are P <0.05，the difference are statistically significant， when compared the clinical curative effectcomprehensive evaluation of group B with group C，by X2test，the result is P>0.05，there is no statistically significant difference.In a ward the surgical time (from the beginning of cutting the skin to the closing ofthe wound)， the loss of intraoperative blood， the mobility of knee joint，complications(infection， bone nonunion or delayed union)， the time of healingfracture， the recent and long-term knee function and comprehensive curative effect ofgroup A have the obvious difference (p <0.05) with group B and group C; Group B andgroup C in operating time (from the beginning of cutting the skin to the closing of thewound)， the loss of intraoperative blood， the mobility of knee joint，complications(infection， bone nonunion or delayed union)， the time of healingfracture， the recent and long-term knee function and comprehensive curative effect haveno significant difference (p>0.05)，but the loss of intraoperative blood of group B andgroup C are also different (p <0.05).Conclusion: The closed reduction interlocking intramedullary nail internal fixationfor treatment of femoral fractures which is superior to open reduction and interlockingintramedullary nail fixation and LCP internal fixation is an ideal surgical method.