Clinical Research Of Ground Beetle Combined With Surgical Therapy In The Treatment Of Middle And Inferior Fracture Of Tibia

Objective:To evaluate the clinical effect of ground beetle combined with interlocking intramedullary nail in the treatment of tibia fracture at the middle and inferior segment and study the traditional Chinese medicine mechanism,which may offer theoretical basis for the clinical therapy and medication.Methods:60patients of tibia fracture were eligible adopted with accurate conclusion standards and exclusion standards,who were collected from July2010to July2011. Patients were divided into two groups randomly:30cases in treatment group were dealed with combination therapy of traditional Chinese medicine and surgical treatment and the other30cases in control group had simple operation.All patients were treated with tibia interlocking intramedullary nail internal fixation,and given rehabilitation training postoperative.The treatment group were given ground beeltle at the2nd post operative day,1.5g once,per os,twice a day,AM and PM,and which was grinded herb powder and was mixed with wine.Take this medicine continually in7weeks and check the hepatic and renal functions at intervals while taking this medication.General data of each patient before operation and the fracture healing time, rate of bone union,growth of osteotylus, the time of loading weight,clinical outcomes postoperative were recorded.X-ray examinations were taken1,3,4,6months after operation, and the date were collected and analyzed by SPSS16.0.Results:There was no significant difference in age, sex, causative factors of injury, fracture position, frature classification, follow-up time between the two groups(P>0.05).All the60cases have been followed up.The rates of bone union at3months postoperationin treatment group and control group were30.0%and16.7%respectively, there was no a significant difference between the two groups(P>0.05).4months after operation,the rate of bone union was90.0%in the treatment group,while that was63.3%in the control group.There was significant difference between the two groups(P<0.05).There was no significant difference in the rate of bone union6months after operation between the treatment group(96.7%) and the control group(90.0%)(P>0.05).The fracture healing time in treatment group(13.0±3.2weeks) was statistical shorter than that in control group(16.2±5.6weeks)(P<0.05). The time of loading weight in treatment group(10.6±2.3weeks) was statistical shorter than that in control group(13.2±3.1weeks)(P<0.05).Based on the X-ray films,Lane-Sandhu’s X-ray grading standard was used to evaluate the growth of osteotylus.3months after operation,the Lane-Sandhu scores in treatment group and control group were1.78±0.32and1.25±0.49respectively,and there was significant difference between the two groups(P<0.05).The Lane-Sandhu score was2.74±0.53in the treatment group,while that was2.32±0.67in the control group. There was significant difference between the two groups(P<0.05).And there was no significant difference in the Lane-Sandhu scores6months after operation between the treatment group(3.41±0.56) and the control group(3.38±0.52)(P>0.05).The rate of excellent and good rate according to the criteria of Johoner-Wruhs was93.3%in the treatment group(28/30) and90.0%in the control group(27/30),without statistically significant difference(P>0.05).There was no obvious adverse effect in the treatment group during dosing or after stopping medication.Conclusion:1.Ground beetle combined with tibia interlocking intramedullary nail internal fixation is fast in bone healing,high rate of bone union,good clinical therapeutic effect into the treatment of tibia fracture.2.The ground beetle is economical and practical,reliable without side-effect and it was well worth clinical popularizing and application.