Clinical analysis of some serious bone fractures limbs

Abstract

Objective To investigate the clinical treatment of multi-severe of long bone. Methods To observe 145 fractures of 76 patients with multi-severe comminuted fracture of long bone,and apply expandable intramedullary nailing, interlocking intramedullary nail fixation, plate fixation, external fixation, artificial joint replacement on these subjects respectively. Results The followed-up period were from 6 months to 21 months after operation, fracture union occurred in two to twelve months. Among all the 145 fractures, bone healing 122 (86. 2％), nonunion 8(5.5％) ,inalunion in 12 cases(8.3％ ). The average healing time:closed fractures (5.5 ± 1.5) months,and open fractures(6.8 ± 1.2 ) months. Expandable intramedullary nailing group, only 1 case of malunion. Interlocking nail group,only 2 cases of nonunion and malunion, and the incidence of nonunion malunion was significantly lower than that of external fixation group and the plate fixation group(P ＜0.05 ) ;In the external fixation group, the healing rate was significantly lower than plate fixation( P ＜ 0. 05) ,but the impact on the adjacent joints in external fixation group was much larger than the intramedullary nail group and the plate fixation group( P ＜ 0.05 ). Conclusion There was no uniform standard of how to select the treatment of long bone fracture currently, surgery should be selected according to the specific injuries of different treatment methods. Expandable intramedullary nailing, interlocking intramedullary nailing were new type of internal fixation material which developed in recent years, and there were fewer complications of the application of interlocking intramedullary nail fixation in fracture healing, and it worths further clinical application in the long bone fracture. Key words: Fractures ; Intramedullary pin; Fixation