| Objective: Tibiofibula comminuted fracture is a relatively common fracture of lower limb,fixed with intramedullary nail,steel plate,external fixator.In the clinical work with steel plate internal fixation treatment,circular external fixation support as the final stable fixation have greater use.Based on the records of these two kinds of operation method of operation time,and after discharge follow-up clinical healing time and lower limb power line,functional recovery,analyzed the advantages and disadvantages of two kinds of treatment.Methods: Prospective analysis in March 2014 to August 2015 patients,42 cases of tibiofibula comminuted fracture patients participate in the study,which use outside the Ilizarov fixator fixation is divided into the treatment group;Points in control group using steel plate internal fixation surgery patients.1.The two groups are unilateral tibiofibula comminuted fracture.Preoperative and postoperative and review of imaging data collection.2.Record the operation time;Measure the length of the preoperative and postoperative tibiofibula,power line,and comparison.Were performed 3.Postoperative bone renew reinforcement decoction oral treatment for a week,the formulas of postoperative 1 month to traditional Chinese medicine fumigation Fang Xun wash treatment.4.After 2 weeks,1 month,2 months,3months,6 months of observation and evaluation.Results: 42 cases in patients with successful 6 months of follow-up 39 cases.These patients were reached clinical healing after 2 months.Ilizarov circular external fixation support group and steel plate internal fixation treatment of tibiofibula comminuted fracture Muller AO classification 42-B,42-C,fixed in place,no fault and loose,no skin necrosis occurred,infection,bone nonunion.Operation time diff,P > 0.05,no statistical significance,consider the reset is difficult as a result of the surgery,no obvious differences in operation time.Two groups of patients in clinical healing days difference was statistically significant(P < 0.05),the circular external fixation support group clinical healing time is time needed for the small steel plate internal fixation.6 weeks after surgery and after 6 months review of X-ray,two time points for varus deformity or valgus size differences,no statistical significance(P values were greater than 0.05),so the two groups of patients after 6 weeks,6 months,no statistically significant difference were observed in the valgus Angle;Two groups of patients with postoperative flexion Angle difference after 6 weeks ago no statistical significance(P > 0.05),while the two groups before and after 6 months postoperatively in patients with flexion Angle differences statistically significant(P < 0.05),the circular external fixation support group of patients before and after 6 months after bending Angle is greater than steel plate internal fixation group.Patients with postoperative treatment followed up to six months,the Johner-Wruh evaluation methods for curative effect evaluation,the results showed Ilizarov circular external fixation support groups: 5 cases,7 cases,3 cases,poor,fine rate reached 80%,and steel plate internal fixation group: 10 cases,8 cases,5cases,1 case of poor,fine rate reached 75%,visible Ilizarov circular external fixation support group curative effect is better than that of the steel plate internal fixation group.Conclusion(s): In the clinical work for patients with anatomicalrepositioning,under the condition of the soft tissue conditions allow,can choose steel screws.Requirements for fracture is not high,under the condition of limb soft tissue condition does not allow,choose outside the Ilizarov fixator.Outside the Ilizarov fixator clinical healing time is superior to the steel plate internal fixation. |
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