Locking Plate And Allograft Bony Plate VS Intramedullary Pin(ORIF)to Treat Old Femoral Shaft Fractures

Objective: To observe the clinical outcome of reamed intramedullary nail( RIN) and locking plate and allograft bony plate in the old femoral shaft fracture,and explore the ideal fixation method in the treatment of the old femoral shaft fractures.Methods: According to inclusion criteria, A retrospective analysis of 97 patients treated in our hospital from October 2004~August 2013 were divided in to LCP group(locking plate and allograft bony plate) and RIN group( intramedullary pin),compared with postoperative bone healing rate, functional recovery.Statistical analysis: Uses SPSS19.0 statistical software, measurement data with X±S said, using t test, count data using ?2test. To evaluate the curative effect of comparison between 2 groups, with P<0.05 as statistically significant differenceResults: The LCP group were followed up 18 to 50 months,The RIN group were followed up 12 to 45 months.(1).LCP group: The 57 patients were fixated with LCP, the operative time respectively were 104.07±30.68 minutes, The intraoperative bleeding loss respectiely were 530.70±172.11 m L. All patients are given follow-up, there were no complications such as interal fixation loosening and there was a case of infection. The fracture healing time respectively were 4.82±1.33 months. According to HSS score: 85.54±10.54, the excellent and good rate was 86.4%.(2) RIN group: The 40 patients were fixated with RIN,, the operative time respectively were 132.35±42.52 minutes, the intraoperative bleeding loss respectively were 412.50±149.25 ml.All patients are given follow-up, no complications such as infection, there was aintenal fixation loosening. The fracture healing time respectively were 5.75±1.93 months. ccording to HSS score: 87.35±14.54, the excellent and good rate was 87.5%.(3). The simple femoral fracture: The 25 patients were fixated with LCP, the operative time respectively were 80.88±15.60 minutes, The intraoperative bleeding loss respectiely were 424.00±133.95 m L. The fracture healing time respectively were 4.04±1.05 months. According to HSS score: 89.60±14.60, the excellent and good rate was 88.0%;The 22 patients were fixated with RIN, the operative time respectively were 113.73±1.23 minutes, the intraoperative bleeding loss respectively were 322.73±93.51 ml.The fracture healing time respectively were 3.65 ± 1.23 months. ccording to HSS score: 90.45±10.54, the excellent and good rate was 86.4%.(4). The complex femoral fractures:The 32 patients were fixated with LCP, the operative time respectively were 122.19±27.20 minutes, The intraoperative bleeding loss respectiely were 614.06±152.52 m L. The fracture healing time respectively were 5.43±1.22 months. According to HSS score: 83.64±15.54, the excellent and good rate was 84.3%;The 18 patients were fixated with RIN, the operative time respectively were 155.11±40.08 minutes, the intraoperative bleeding loss respectively were 522.22±130.861 ml.The fracture healing time respectively were 6.78±1.86 months. ccording to HSS score: 85.85±12.67,the excellent and good rate was 83.3%.(5). Statistical analysis results:(1):There is no significant differences in the HSS assessment at one year after surgery;(2):There are significant differences in union time in both thesimple and the complex femoral fracture?(3) There are significant differences in operation time and intraoperative bleeding loss in both Simple and Complex fractures.Conclusions: The clinical effect of two groups were significantly effective. If it's difficult to treat fracture with intramedullary nail for minimally invasive treatment, the use of locking plate with allograft bone plate may be a more simple operation scheme. It suggest using locking plate and allograft bony plate to treat simple fractures,intramedullary pin to treat complex fractures.