Application Value Analysis Of Locking Plates And Reamed Intramedullary Nailing In The Treatment Of Tibial Nonunion

BackgroundAs well as the rapid development of society, traffic injury and other safety accidents such as high-energy injury which cause complex limbs long bone fracture incidence are higher and higher, in recent years, the incidence of tibial fractures shows a trend of rising year by year. Due to bone destruction of the local blood supply after a fracture, soft tissue damage after he broke in, coupled with inappropriate internal and external fixation, easily lead to various complications.Among the more common is fracture delayed union, severe cases will not heal. Nonunion of long bone fracture after trauma is very common clinical disease, and achieves the incidence of 5%-10%. Once fracture unhealing appear, it will lead to loss of labor, disabling and serious consequences.Nonunion of fracture induce limb pain and disfunction and psychological shadows, bring great misery to the sufferer and a heavy financial burden, seriously affect patients quality of life and the ability to work.Treatment of fracture nonunion is still one of the most urgent problems to be solved.With the development of medical technology, as well as new technologies continue to improve, offer new hope for patients with tibial fracture nonunion. With a greater incidence of tibia for fracture nonunion, tibial fracture nonunion is a hotspot of research on fracture healing treatment.ObjectiveTo analyze the application value of locking plates and reamed intramedullary nailing in the treatment of tibial nonunion.Methods50 cases of tibial nonunion patients in our hospital from May 2012 to May 2014 were selected, these patients were divided into two groups, locking plate group and intramedullary nail group according to a random number table,25 cases in each group. The locking plate group of patients were given locking plate fixation, while the intramedullary nail group of patients were given reamed intramedullary nail fixation, then the operation time, fracture healing time, callus growth score after three months and six months, preoperative difference after six months of knee and ankle joints functional scores of the two groups of patients were statistically compared.Results1. The operation time and fracture healing time were compared. Locking plate group of patients with operative time (125±15.38) minutes significantly longer than the intramedullary nail group (110±16.40) minutes (P<0.05), but the two groups of patients with fracture healing time difference were not significant (P> 0.05).2. The callus growth rates after three months and six months were compared.Locking plate group patients after three months and six months callus growth rates were (2.20±0.50) points, (3.32±0.48) points and the intramedullary nail group were(2.45±032) points (3.75±0.42) scores, the difference between the two groups of patients callus growth rates were not significant (P> 0.05).3. Groups of patients after six months HSS score (89.78±8.24) points, (88.56±7.67) points and ankle Kofoed score (89.58±10.24) points, (88.38±11.60) scores were significantly higher than preoperative (52.34±18.38) points, (54.33±19 87) points and (68.84±20.38) points, (65.67±18.87) points (P<0.05), but the difference between the two groups of patients before and after surgery six months-HSS score and ankle Kofoed score were not significant (P> 0.05).ConclusionIn the tibial nonunion treatment, the locking plate and reamed intramedullary nailing all have exact effects and high cure rates.