Clinical Curative Effective Observation Of Minimally Invasive Surgery Combined With Traditional Herbal Medicine By Stages On Children's Middle And Lower Tibial Fractures

Objective: To retrospectively evalute both clinical curative efficacy of fixation with minimal invasive external fixator and minimally invasive percutaneous plate osteosynthesis with traditional herbal medicine in the treatment of middle and lower tibial fractures in children,in order to provide a reference for clinical treatment.Methods: From January 2016 to May 2017,40 patients with fresh closed tibial fractures in the middle and lower segment were selected in Affiliated Hosipital of Shandong University of Traditional Chinese Medicine Department of Pediatric Orthopaedic Ward,Which were assigned into two groups according to different treatment:fixation of minimal invasive external fixator(MIEFF)group of 20 cases;minimally invasive percutaneous plate osteosynthesis(MIPPO)group of 20 cases.The two groups were treated with three dialectical therapy after hospitalization.Early fracture oral Taohong Siwu decoction,the medium oral Shujin Huoxue decoction,the late oral Bushen Zhugu decoction.Observe two sets of limb swelling,operative time,blood loss,Postoperative complcation,hospitalization days,follow-up callus formation time,fracture clinical healing time,fracture bone healing time and postoperative clinical effect of patients with fracture healing time of the tibial fractures(Johner&Wruhs)efficacy evaluation criteria to assess function assessment of minimal invasive external fixator and minimally invasive percutaneous plate osteosynthesis of the therapeutic effect.Results: All patients were followed up for 9~12 months,and the fracture healed well.During the follow-up period,there were neihter failure nor fracture of internal fixation needle,the stitchs healed well after the remoal of the external fixator.There were no cases of delayed union,nonunion and osteomyelitis.There were significant difference between two groups in operation time and operative bleeding volume(P<0.05);hospitalization days,callus formation time,fracture clinical healing time and fracture bone healing time in both groups were basically matched and balanced(P>0.05).Finally,using the efficacy evaluation criteria of tibial fractures(Johner&Wruhs)to assess the affected limb:the excellent and good rate of MIEFF group and MIPPO group achieved respectively 90.00% and 85.00%,The mentioned difference had no statistical sense in the two groups(P>0.05).There were no significant difference between two groups in incidence of postoperative complications(P<0.05).Conclusion: 1.Both MIEFF and MIPPO in the treatment of middle and lower tibial fractures in children finally curative effect have no significant difference.2.The operative time and intraoperaive bleeding of MIEEF were less than the MIPPO and the scope of application of MIEFF is more wider.What's more,the removal of external fixator does not require secondary surgery,it is more helpful to alleviate the pain of patients and reduce the cost of treatment.Therefore,the surgical treatment of children tibal fractures should be based on the type of fracture,position,soft tissue conditions,age,general condition and the advantages,disadvantages and indication of different surgical methods to take appropriate therapeutic measures.3.According to traditional Chinese medicine three dialectical Oral traditional Chinese herbal medicine preparation can improve the fracture blood circulation,Promote swelling,Fracture healing,Pain relief,Limb function after quick recovery,Fewer complications.Its results were satisfactory,safe and reliable.4.Minimally invasive surgery with the the three dialectical treatment of children with tibial fractures,Can effectively reduce the suffering of patients,Reduce postoperative complications,Early limb functional exercise,And reduce hospitalization time,Reduce the cost of treatment,Embodies the advantages of integrative medicine.