Compare The Curatuve Effects Of Interlocking Intramedullary Nail And Locking Pressure Plate To Treat The Lower Tibia Fracture

Objective:Lower tibial fractures are one of the more common fractures in clinical practice,mostly due to high energy damage.Due to the lower tibial anatomical structure of the lower,soft tissue coverage and poor blood supply,easy to lead to fracture after fracture healing,non-healing [1].Therefore,in the treatment of lower tibial fractures in the process,the effective protection of fracture off the end of blood supply,reduce the damage to soft tissue and outer adventitia is to improve the clinical treatment of the key.Interlocking intramedullary nail fixation and locking compression plate fixation is currently the lower tibial fractures are more commonly used in two kinds of surgical fixation,but its pros and cons remains controversial.The aim of this study is to compare the clinical efficacy of interlocking intramedullary nail and locking compression plate in the treatment of lower tibial fractures,and to provide the basis for the choice of surgical methodsMethods:Retrospective analysis of May 2013 to November 2015 in our hospital admitted to 94 patients with lower tibial fractures as the object of study.55 males and 39 females.Aged between 21 and 64 years old,with an average age of(40.9 ± 3.1)years.Fractures in accordance with AO classification: 38 cases of type A fractures,27 cases of type B,29 cases of type C.Combined with fibula fractures in 31 cases;all patients were randomly divided into A,B two groups,A group of 51 cases of interlocking intramedullary nail fixation,B group of 43 cases of locking compression plate internal fixation.There was no statistically significant difference between the two groups in age,sex,fracture type,combined injury,etc.(P> 0.05,Table 1),comparable.To observe the twogroups of patients with intraoperative and postoperative efficacy.Surgery was recorded by the same group of incision length,operation time,intraoperative bleeding volume and other related data,follow-up records of patients with strict fracture healing time and postoperative effect.Postoperative rehabilitation training by our hospital rehabilitation group of the same group of rehabilitation technicians to guide.The first day after the first day of bedside knee,ankle function exercises,every other day dressing,prevention of infection,2 weeks after the removal of sutures;at the same time after discharge to actively encourage patients to knee,ankle function exercise,at this time to prohibit weight;Fracture healing after the first 6-10 weeks before the start part of the weight,to be fractured after healing,to fully weight-bearing.All patients were followed up for 18 to 24 months.The incidence of fracture healing and the occurrence of complications were compared between the two groups at 4 weeks,8 weeks,12 weeks,half year,1year and 2 years.The data of intraoperative and postoperative follow-up were analyzed by SPSS19.0 software,The difference was statistically significant(P<0.05).Results:All patients were followed up for 18 to 24 months,an average of 21.3months,all patients were bone healing,no internal fixation loose fracture,nonunion and other complications.There was no significant difference in operation time and operation outcome between group A and group B(P> 0.05,Table 2).The intraoperative blood loss and fracture healing time of group A were lower than those of group A B group,the difference was statistically significant(P <0.05,Table 2).Conclusion:Through this study can be obtained,locking compression plate internal fixation for the traditional treatment of lower tibial fractures of the surgical approach,its operation is simple,good fixation effect,but this method is open reduction,surgery should be fully exposed fracture,Fractures around the soft tissue damage larger,destruction of blood,easily lead to local skin necrosis,limb dysfunction.Compared with the plate group,the intramedullary nail group was more satisfactory after operation,intramedullary fixation can effectively reduce the damage to the outer membrane and soft tissue,the greatest reduction in surgical incision and reduce intraoperative blood loss,reduce its The incidence of postoperative complications,shorten the time of fracture healing.