Clinical Effect Observation On The Treatment Of Unstable Fracture Of Tibiofibula With Two Types Of Manual Reduction Fixation

Objective:To seek a reliable treatment by discussing the clinical effect of manual reduction with interlocking intramedullary nail fixation and external fixation with single arm in the treatment of unstable fracture of the tibiofibula.Methods:Select 60 patients of unstable fracture of the tibiofibula meeting the inclusion criteria and divide them randomly into treatment group(30 cases,treated with manual reduction with interlocking intramedullary nail fixation)and control group(30 cases,treated with manual reduction with single arm external fixation).Cases from each group received routine medication after operation.The intraoperative blood loss,fracture healing time,postoperative infection and curative effect evaluation of the two operations were compared and analysed with statistical method.Results:After 6-12 months' follow-up,all fractures were primary healing,and the healing time was 12-26 weeks,an average of 18.7weeks.Comparing the operative duration and intraoperative blood loss,there was no significant difference between two groups(P<0.05);fracture healing time in the treatment group was 17.33±3.49 weeks and 20.00±4.57 weeks in the control group.There was no infection in treatment group and 2 superficial infection cases in control group.Deep infection did not occur in both groups.The infection rate in control group was 6.7%,and there was no significant difference(P>0.05).In terms of percentage,it is higher in control group than in treatment group.All the infection cases received secondary debridement,sensitive antibiotic treatment,regularly dressing replacement and alcohol applyment on needle eyes.All wounds healed.In terms of efficacy evaluation after healing,both groups used Johner-wruhs scores and Mazur ankle rating system.Johner-wruhs score in treatment group is 93.3%and 96.7%in control group.While Mazur ankle score in treatment group is 93.3%and 90.0%in control group.Two scores of the two groups are no significant difference.Consequently,there is no significant difference in the efficacy of the two groups after healing.Conclusions:Manual reduction with interlocking intramedullary nail fixation and external fixation with single arm are effective treatment for unstable fracture of the tibiofibula,both with less injury and high healing rate.But with interlocking intramedullary nail fixation,the fixation is firmer,healing time is shorter and infection rate is lower.External fixation with single arm is simply operated and can be demolition without secondary surgery,but the nail hole infection rate is higher.