Clinical Application Of Bridge Combined Fixation System In The Treatment Of Comminuted Femoral Shaft Fractures

OBJECTIVE To observed the clinical application of bridge combined fixation system and locking plate for comminuted fracture of femoral shaft in the study,and compared the intraoperative and postoperative statistical indexes of two ways.We also compared the advantages and disadvantages of two internal fixation methods for the treatment of comminuted femoral shaft fractures,and summarized the experience of the application of the bridge combined fixation system and the locking plate for the treatment of femoral comminuted fractures.It is hoped that this study will provide a theoretical basis for surgeons to choose internal fixation methods for the treatment of comminuted femoral fractures.METHODS This prospective study was performed in this study.According to the inclusion and exclusion criteria,forty-six patients with unilateral femoral comminuted fractures of unilateral femoral shaft were collected from December 2016 to December 2018.[Forty cases were planned,forty-six cases were actually admitted,including 28 males and 18 females.Ages ranged from 22 to 74,(AO/OTA)classification: 33 cases of type B,13 cases of type C];patients were randomly divided into the bridge combined fixation system group(observation group)and the locking plate group(control group)according to random number table method,the observation group was treated with bridge combined fixation system,while the control group was treated with locking plate fixation.The intraoperative blood loss,duration of operation,fracture reduction,and postoperative follow-up times were recorded.Postoperative follow-up was from 8 to 18 months,The average follow-up time was 13 months.The functional evaluation of affected limbs(Kolmert functional evaluation)and the healing time of fracture were recorded at the same time.In addition,the occurrence of complications such as failure of internal fixation,infection,malunion and nonunion of fracture after operation were included in the index range.The experimental data of the observation group and the control group were statistically processed,and the advantages and disadvantages of the two internal fixation methods for the treatment of comminuted femoral shaft fractures were analyzed and compared.RESULTS All patients were successed follow-up.Statistical analysis were performed on the age,gender,fracture AO classification and follow-up time of the observation group and the control group.The difference was not statistically significant.In the observation group,the average of the intraoperative blood loss was 193.48±57.89 ml,the average time of the operation was 97.22±15.53 min,the fracture anatomical reduction was 19 cases,the functional reduction was 4 cases,and the average fracture healing time was 19.74±3.18 weeks.At the last follow-up,the excellent rate of Kolmert function assessment was 91.30%.Among them,two cases were infected but recovered after treatment with sensitive antibiotics.There were no other complications such as nonunion and fracture of internal fixation.In the control group,the average intraoperative blood loss was 237.83±84.37 ml,and the average operation duration was 107.48±16.69 min,and there were 12 cases of fracture anatomical reduction and 11 cases of functional reduction.The average fracture healing time was 20.26±2.52 weeks.The excellent rate of Kolmert function assessment was 86.95%.One case of wound infection was treated with sensitive antibiotics.One patient had nonunion of fracture,and bone union was recoverd after re-operation and bone grafting.There were no other complications such as malunion of fracture.There were statistical differences between the two groups in the operation time,intraoperative blood loss and fracture reduction index(P<0.05).There was no significant difference between the two groups in the fracture healing time and the excellent rate of Kolmert function evaluation(P>0.05).Conclusion There is no significant difference in the efficacy between bridge combined fixation system and locking plate in the treatment of comminuted fractures of the femur,but there are statistical differences between the two groups in terms of operation time,intraoperative blood loss and fracture reduction.Because of its individualized design,the bridge combined fixation system can assist the fracture open reduction,unique personalized design and three-dimensional fixed mode to reduce the loss of fracture reduction.Compared with the locking plate,it can effectively shorten the operation time and reduce the amount of bleeding,reducing the risk of operation.