| Objectives Comparison of effects of cure Fraser I type floating knee injury tibial fractures by interlocking intramedullary nail and locking plate fixation,further analysis of two different fixation methods whether there are statistically significant in surgery mean time, blood loss, time appeared callus, load time, the average healing time, postoperative efficacy, complications,provide the necessary basis for Fraser I type floating fractures and the tibial knee injury.Methods Selecting 45 cases of injury were floating kenn paint Fraser I type were treated by Hebei orthopedic trauma center(The Second Hospital of Tangshan) in period of January 2009- December 2013 by A retrospective analysis, femoral treated by using interlocking intramedullary nail, They will be divided into two groups, interlocking intramedullary nail group and locking plate group, depending on different methods of the tibial fixation, follow-up of 12 to 36 months, with an average 24.5 ± 1.5months,Interlocking intramedullary nail group of 23 cases, including 13 males and 10 females, aged 18 to 56 years, mean 38.5 ± 2.5 years old, the left side of 12 cases, the right11 cases. Cause of injury: 10 cases of traffic injuries, falls injury in 8 cases, 5 cases of crush injury; 2 cases of merge abdominal organ injury, chest trauma 2 cases; 1 case of traumatic brain injury. 22 cases in locking plate group, including 12 males and 10 females,Aged 18 to 58 years, mean 38.5 ± 2.5 years old. left side of 10 cases, the right side 12 cases, Cause of injury: 11 cases of traffic injuries, falls injury in 7 cases, 4 cases of crush injury; The combined abdominal organ injury in 3 cases, 1 case of chest trauma; 1 case of traumatic brain injury. Comparing two different fixation methods in surgery mean time,blood loss, time appeared callus, load time, the average healing time, postoperative efficacy of postoperative complications.Results 45 patients were followed up. Interlocking intramedullary nail group and locking plate group has no significant difference in terms of comparable age, gender, left and right,cause of injury, etc.(P>0.05),Interlocking intramedullary nail group mean operative time was 90.09 ± 9.19 min, locking plates was 94.73 ± 10.39 min, showed no significant difference(P>0.05) between operative time and postoperative complications. according to the evaluation, of Karlstrom and Olerud functional criteria, Interlocking intramedullarynail group: Excellent for 18 cases, good for 2 cases, bad for 3 cases, the difference is 0cases, good rate of 87%; Locking plate group: Excellent for 11 cases, good for 2 cases, bad for 7 cases, the difference is 2 cases, good rate of 59.1%, Interlocking intramedullary nailing after excellent higher rate than locking plate group, compared in blood loss, bone callus time, load time, the average healing time, interlocking intramedullary nail group:Were 248.74 ± 43.23 ml, 2.16 ± 0.45 months, 3.22 ± 0.45 months, 11.30 ± 1.94 months,Locking plate group: Were 322.95 ± 43.39 ml, 2.94 ± 0.45 months, 4.83 ± 0.69 months,13.42 ± 1.66 months, Two groups, the time of interlocking intramedullary nail group shorter than the locking plate group, a statistically significant difference between(P <0.05).Conclusions In addition to operative time and postoperative complications were no significant differences, interlocking intramedullary nail group were significantly superior locking plate group in blood loss, bone callus time, load time, the average healing time,postoperative good rate, Interlocking intramedullary nail group, increasing the likelihood of early exercise, effectively promote fracture healing, curbed the incidence of muscle atrophy and joint stiffness and other complications, Although interlocking intramedullary nail and locking plate to promote fracture healing from mechanical and biological point of view, has its own characteristics and indications, but interlocking intramedullary nail have advantages of a fixed and stable, easy to fracture healing, reduce infection rates, reduce blood loss, lower fixation failure rate and so on, Can be used as simple as the preferred method of long bone shaft fractures. |
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