| ObjectivesClinical multiple fractures of tibia and fibula,in the general long-bone fractures in the highest incidence of all lower leg fractures account for about 10%,and with the construction industry and growing traffic,and its incidence was rising trend year by year.Open comminuted tibia and fibula fracture using external fixation single,simple operation, excellent high rate of fracture healing,the healing time is short,low complication rate.Discussion of this topic GustiloⅡtype,Ⅲa type,Ⅲb type of tibial fracture external fixation arm superiority,as well as the treatment of post-operative complications;and compare the single-arm external fixator in fracture healing power after the mid-and late on fracture healing.methods57 cases of patients from September 2006 to June 2008 for medical treatment in Chinese medicine hospital in Hubei Province and Wuhan General Hospital of Guangzhou Military Region Orthopedic open comminuted tibial fracture patients are in line with GustiloⅡtype,Ⅲa type,Ⅲb type tibial fracture-based selection criteria.All cases the use of external fixation arm,generally about 60 days,when the X-ray film after the initial formation of bone callus,were randomly divided into fracture healing power of the latter group(referred to as dynamic group,30 cases) and fracture healing in the late no power of group(not power of group,27 cases),in which the implementation of dynamic external fixator group dynamic adjustment of the extension of the arm lock New dynamic external fixator,and to reduce the shielding effect of fracture fixation by a rigid fixed variable elastic constant and close observation of external fixation pins and the direction of the elastic and timely adjustment.No power no power of group treatment,only observation of external fixation pins and the direction of the elastic and timely adjustments,not to extend the lock New Zealand,does not reduce the vertical stress shielding.All patients were followed up for 2～12 months,and compare the efficacy of two excellent and good rate,healing time and the rate of delayed healing and infection.Results1.Effect after the use of the excellent and good rate Johner-Wruh criteria,48 cases of excellent and good rate,accounting for 84.2%of the total number of cases;The average healing time was 5 months;nine cases of delayed union,accounting for 15.8%of the total number of cases; seven cases of infection,accounting for 12.3%of the total number of cases;2.Dynamic group of excellent efficacy rate of 93.3%,no effect of dynamic group of excellent and good rate was 74.1%,both excellent efficacy rates significantly different(P<0.05);3.Group dynamics of fracture healing time for an average of 3.5±2 months,does not mean the healing power of time is 5±2.5 months,the healing time of the two groups were significantly different(P<0.05);4.Power of group 2 cases of delayed union of fracture,accounting for 6.7%of non-power group seven cases of delayed union of fracture, accounting for 25.9%.The two groups was significant difference(p <0.05);5.Dynamic group of three cases of superficial infection,1 case of deep infection,non-dynamic group of superficial infection in two cases,1 case of deep infection,two rates were 13.3%and 11.1%,there was no significant difference(P>0.05).Conclusions1.Single external fixation fixator in the treatment of open tibial comminuted fracture with a short course of treatment,trauma,fixed effects,and the high rate of fracture healing,infection rate low,the rapid recovery of the unique therapeutic effects.2.Fracture healing in the late implementation of dynamic external fixation,fracture healing was significantly more than the fine is not power of group dynamics and group healing time was significantly shorter than that of non-power group.3.Treatment in clinical GustiloⅡtype,Ⅲa type,Ⅲb type tibial fracture-type external fixator fixation is the preferred way,in the mid-and late fracture healing by external fixation flexibility into a rigid fixed-fixed, that is,dynamic external fixator,the fracture can promote better and more faster healing.
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