Combined With Intramedullary Nail In Treatment Of Tibial Fracture Nonunion With Locking Plate

Objective:This article locking intramedullary nail plate through a joint retrospective case analysis of the intramedullary nail to replace only the therapeutic effect of tibial nonunion to evaluate the therapeutic effect of these two methods of clinical fracture nonunion, to explore for tibial fracture nonunion treatment. Methods:From January 2004 to O1 to January 2014, we were treated tibial nonunion fracture surgery patients with 45 cases. Follow-up to cases in which a total of 39 cases, 29 males and 10 females. Age range 18 to 60 years, mean age 39.0 years old. Follow-up of cases of road accident trauma in 17 cases, 12 cases of heavy crushing injury, falls falls 10 cases. According to the site of the fracture: the upper tibia in 15 cases, under section 24 cases. By x-ray examination results are: hypertrophic nonunion, 30 cases of atrophic nonunion nine cases. Revenue from the hospital when the initial surgery takes about 12-60 months, mean 29.3 months. Initial choice of treatment: plate fixation in 23 cases, 11 cases of intramedullary nail fixation, external fixation in 5 cases. Secondary treatment of 21 cases to be reamed intramedullary nailing without replacement and the addition of locked steel fixed, and all patients had bone graft, defined as the locking plate group. 18 cases of intramedullary nail to be replaced, and all patients had bone graft, defined as the intramedullary nail group. Were 1,3,6,12 months later after the second X-ray. In comparing the two groups of patients to be operative time, postoperative March callus growth rates, fracture healing time, and after 6 months of knee, ankle function score difference aspects and statistical analysis, respectively. Results: The two groups of patients followed up for approximately 6-18 months for an average of 10 months. 1, the average operative time locking plate combined with intramedullary nail group(125 soil 15.35min); intramedullary nail group(11 0 ± 16.26min); statistically significant. 2, the average healing time of clinical fractures was no significant difference between the two groups. 3, 3 months after callus growth rates locking plate group than replace high intramedullary nail group(p <O.05), with a statistically significant difference. 4, after six months of knee, ankle functional scores improved significantly in both groups. Between the two groups of knee, ankle function was no significant difference. Conclusions:1, locking plate combined treatment of tibial intramedullary nail nonunion effective. You can reduce the cost of surgery and rehabilitation exercise to early functional recovery is good, high cure rate, the treatment of tibial nonunion good choice. 2, fracture due to instability caused by the fracture nonunion using locking plate combined with reamed intramedullary nailing in the treatment and effective.