The Clinical Research Of Locked Intramedullary Nail Combined With LCP In Treating Nonunion Of Long Tubular Bone

Objectives:We explored the results of locked intramedullary nail combined withLCP in treating nonunion of long tubular bone and analyzed theintraoperative and postoperative data to provide the basis for the choice ofsurgical procedure in treating nonunion of long tubular bone.Methods:We reviewed and analyzed22patients with nonunion of long tubularbone between Jan,2010and Mar,2013in department of orthopedictraumatology of The First Hospital of Jilin University. There are15malesand7females aged22～65y.The period of nonunion was ranging from10m to50m. The average follow-up duration was17.05months (range，12–24months). The reasons of injury included falling from height(8/22),traffic accident(10/22) and tumble injury(4/22). There are17cases in thefemur and5cases in the tibia. Eighteen cases were hypertrophianonunion and four cases were atrophic nonunion. Eighteen casesaccompanied with the failure of internal fixation. Ten patients weretreated by locked intramedullary nail combined with LCP (theexperimental group), and twelve patients were treated by lockedintramedullary nail without LCP (the control group). All the patients received iliac graft and were achieved follow-up，the collected data wereanalyzed retrospectively. The main outcome measures includedhospitalization days, operation time, operation blood loss, hospitalizationcost, part weight bearing time, union rate，time to union, re-operationrate,AAOS scores. The correlative data was measured and analyzed bySPSS17.0Results:1.Part weight bearing time, time to union, union rate， re-operationrate, AAOS scores comparison: the experimental group,2.85±0.71m,8.30±1.14m,100%,0,89.70±2.00; the control group,3.58±0.87m,10.50±1.82m,58.3%,41.7%,85.67±1.82.There were statistical significancedifference between the two groups(p＜0.05). The experimental group inthe above aspects was better than that of the control group.2.Operation time, hospitalization cost comparison: The experimentalgroup,237.2±49.97min、50796.36±4541.79RMB; The control group,201.33±18.89min,31461.41±4714.70.There were statistical significancedifference between the two groups(p＜0.05). The control group in theabove aspects was better than that of the experimental group.3.Hospitalization days， operation blood loss comparison： theexperimental group，12.40±3.20d,797.00±133.92ml；the control group,12.00±2.92d,745.83±119.50ml; There was no significant differencebetween the two groups（p＞0.05）. Conclusion:1.The treatment of locked intramedullary nail combined with LCP isbetter in part weight bearing time, union rate，time to union, re-operationrate and AAOS scores, the curative effect of the experimental group isbetter than that of the control group.2.The way of locked intramedullarynail combined with LCP can provide more reliable fixation andguarantee for early functional exercise and weight bearing.