Effects Of Closed Reduction And Internal Fixation Of Bone Block Size And Shift Degree On Fracture Healing Of Femoral Shaft Type B Fractures

Objectives To investigate the effect of displaced bone mass on fracture healing in patients with femoral shaft fracture treated with interlocking intramedullary nail.Methods Through a retrospective analysis of 174 cases of femoral shaft fractures in recent years,the subjects were treated with interlocking intramedullary nail.According to the size and distance of the displaced bone in patients after surgery,these subjects were divided into 4 groups: group A(the area of displaced bone mass is less than or equal to fifteen square centimeters,the shift distance of bone mass is less than or equal to ten millimeter)had sixty patients,and the group B(the area of free fracture block is less than or equal to fifteen square centimeters,the shift distance of bone mass is greater than ten less than twenty millimeter)had twenty-seven patients.group C(the area of free fracture block is greater than fifteen less than thirty square centimeters,the shift distance of bone mass is less than or equal to ten millimeter)had sixty-two patients.the group D(the area of free fracture block is greater than fifteen less than thirty square centimeters,the shift distance of bone mass is greater than ten less than twenty millimeter)had twenty-five patients.Then to compared the fracture healing time,the delayed healing rate,the total healing rate and the postoperative clinical curative effect of the four groups,the measurement date useing t test,the enumeration date useing chi square test.Results All patients' surgical incision healed normally,the average follow-up time was(16.50±4.25)by telephone or reexamination,Group A: the fracture healing time was(3.80±0.55)months,the delayed healing rate of fracture was 6.67%,the fracture healing rate was 98.33%,the excellent rate was 96.67%.Group B: the fracture healing time was(6.10±0.53)months,the delayed healing rate of fracture was 25.93%,the healing rate of fracture was 81.48%,the excellent rate was 77.78%.Group C: the fracture healing time was(4.5±0.62)months,the delayed healing rate of fracture was 19.35%,the healing rate of fracture was 87.10%,the excellent rate was 83.87%.Group D: the fracture healing time was(7.50±0.61)months,the delayed healing rate of fracture was 56.00%,the healing rate of fracture was 56.00%,the excellent rate was 48.00%.Comparison between the four groups,the indicators were all statistically significant.Conclusions The displaced bone mass have bad influence on fracture healing.With the increase of the shift distance and area of the bone block,the fracture healing will become worse.Therefore,when using interlocking intramedullary nail in the treatment of type B femoral shaft fracture,the patients with displaced bone mass(the area of free fracture block is greater than fifteen square centimeters and the shift distance of bone mass is greater than ten millimeter)should be given adequate attention,in case of postoperative complications.