Clinical Study Efficacy Of Tibial Shaft Fracture Of The Three Surgical Methods

Subject:Investigate the Clinical efficacy of three different surgical methods to therapy the lower tibial fractures.Materials and methods: Collect and analyze data on patients in The Second Affiliated Hospital of Dalian Medical University from June 2013 to September 2014.Selected 54 cases of eligible patients, Including 29 males, 25 females. According to different surgical methods the patient were divided into three groups( Group A, B and C). Surgical procedure of Group A was open reduction and dynamic compression plate(DCP)fixation.Group B was closed reduction and intramedullar inter locking nail.Group C was closed reduction and minimally invasive plate oateosythesis(MIPO) with locking compression plate(LCP). By comparing the clinical, postoperative indicators and johner-wruhs scoring methods to assess the clinical efficacy of three different surgical methods to therapy the lower tibial fractures.Result: Compared with clinical indicators just like the operative time, blood loss, incision size, healing time and the risk of infection, whether group B or C both has a statistically significant with Group A(P<0.05).Among all of indicators indicators the was no indicators between Group B and C(P> 0.05).Evaluation by Johner-Wruhs scoring method, there were two cases of infection,one case of broken plates(nail),two cases of joint pain in Group A, excellent rate was 80.9%. In Group B infection and joint pain both was one case, excellent rate was 86.6%. Group C, one case of infection and two cases of joint pain, excellent rate was 88.8%.Contradistinction of contradistinction between two groups there was no Statistically significant(P>0.05).Conclutions: Three kinds of surgical approach were all effective treatment options for the lower tibial fractures. Through a comparative analysis on the indications open reduction and internal fixation is applied more widely. In biomechanics, either intramedullar inter locking nail or minimally invasive plate oateosythesis with locking compression plate methods are advantages. As for the choice of which was the best solution of surgical approach for the lower tibial fractures should be not only experienced by the surgeon, fracture type, and the patient’s condition but also the other factors, to develop individualized treatment programs.