The Clinical Analysis About Two Fixation Methods For Tibial Fracture

Objective: The purpose of the study is to explore the clinical results of the locking compression plate(LCP) via the expert tibia nail(ETN) for the fractures of tibial, we studied the feasibility and effectiveness of two fixation methods for tibial fracture in order to provide a theoretical basis for tibial fractures treatment.Methods: A hospital-based clinical study, which has conducted between Oct, 2012 and Aug, 2014 in Yan’an, was carried out to assess the clinical results of the ETN via the LCP for the fractures of tibial. Subjects were divided into the ETN(Group A) and the LCP(Group B) according to different fixation methods. A total of 25 patients were applied ETN treatment in Group A, and 23 were used LCP treatment in Group B. The studying targets involved in age, sex, injury cause, the time of preparation for surgery and operation, and the blood loss volume during operation, the length of hospital stay, the time of full weight bearing and the time of bone union were compared among Group A and Group B. Software SPSS 22.0 was applied to analyze the difference in studying targets among different groups. All statistical tests were two-sides.Results: 1) All patients were followed up for 3-12 months(average 7.8 months). There were no significant differences in aspects of age, sex, injury cause, AO classification, combined injury(yes or no) and fibular fractures(yes or no) between the two groups(P=0.873, 0.951, 0.706, 0.882, 0.990, 0.950, 0.752).2) There were no significant differences in aspects of the time of preparation for surgery between the two groups(P=0.090). The difference of the time of operation and the blood loss volume during operation were of statistical significance(P=0.000, 0.001).3) There were no significant differences in aspects of the length of hospital stay, the time of full weight bearing between the two groups(P=0.102, 0.091,). The differences of the time of bone union were of statistical significance(P=0.045).4) There were no significant differences in aspects of postoperative complication(P=0.320).5) Johner-wruhs ratings—a standard ingredient in effect, including Group A what the group good rate for 84% and Group B good rate for 82.6%, there was no significant(P=0.500).6) Ovadia-- a standard ingredient in effect, including Group A what the group good rate for 88% and Group B good rate for 82.6%, there was no significance(P=0.832).Conclusion: The results suggest that ETN group has a wide range of application and obvious advantages, involved in treatment of tibia, distal stem epiphyseal end, tibial stem, and unstable distal tibial fracture, especially suitable for soft tissue condition and early fixed plate, having good advantage with postoperative recovery. LCP group can shorten the operation time, better reach anatomical reduction, and also have distinct advantages for the treatment of distal tibial fracture, osteoporotic fracture, multiple segmental fracture and people with poor economic condition.Both fixation effects are satisfied in curative effect evaluation standard in terms of the postoperative complications, full load time, the total length of hospital stay, ankle symptoms and functional score(Mazur) and tibial fractures(Johner & Wruhs). Both two methods are worth to promote in the clinical practice, and the appropriate treatment should be chosen according to the actual situation, fracture type, basic diseases and medical conditions, and economic conditions, etc.