Efficacy comparison of circular external fixator and intramedullary nail in treating segmental tibial fractures
10.3760/cma.j.cn501098-20210524-00317
- VernacularTitle:环形外固定架与髓内钉治疗胫骨节段性骨折的疗效比较
- Author:
Peng JIA
1
;
Hongchuan WANG
;
Bowen SHI
;
Hengsheng SHU
Author Information
1. 天津医院创伤骨科 300211
- Keywords:
Tibial fractures;
External fixators;
Fracture fixation，intramedullary
- From:
Chinese Journal of Trauma
2021;37(9):818-824
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical effect of circular external fixator and intramedullary nail in treatment of tibial segmental fractures.Methods:A retrospective case control study was performed on clinical data of 43 patients with segmental tibial fractures treated from January 2006 to December 2012 in Tianjin Hospital. There were 31 males and 12 females with age range of 20-60 years［（35.9±9.6）years］. All fractures were classified as type 42C2 using the AO/OTA classification. A total of 21 patients treated with circular external fixator（circular fixator group）and 22 patients were treated with intramedullary nail（intramedullary nail group）. The condition of vascular and neural injuries，methods of fracture reduction，time of full weight bearing，bone healing time and infection rate were compared between the two groups. The proximal tibial medial angle，proximal tibial posterior angle，IOWA knee and ankle joint score，range of motion of flexion of keen joint and range of motion of plantar flexion and dorsal flexion of ankle joint were compared between the two groups at the last follow-up.Results:All patients were followed up for 12- 48 months［（19.6±2.1）months］. There were no vascular and neural injuries or other severe complications in both groups. All 21 patients in circular fixator group underwent closed reduction but 3 patients in intramellary nail group were treated by open reduction. The time of full weight bearing was（12.9±2.8）days and in circular fixator group and（75.1±8.0）days in intramedullary nail group（ P<0.05），with bone healing time for（7.0±1.0）months and（8.2±1.4）months，respectively（ P<0.05）. There was no deep infection in both groups. In circular fixator group and intramedullary nail group，the proximal tibial medial angle was（86.7±1.5）° and（93.5±1.7）°（ P<0.05），while the proximal tibial posterior angle was（82.1±1.8）°and（75.1±2.7）°（ P<0.05）. No significant differences were found between the two groups at the last follow-up concerning IOWA knee and joint score，range of motion of flexion of keen joint and range of motion of plantar flexion of ankle joint（ P>0.05）. The range of motion of dorsal flexion of ankle joint in intramedullary nail group was（30.9±3.0）°，better than（21.2±2.2）° in circular fixator group（ P<0.05）. Conclusion:For segmental tibial fractures，cirlular external fixation is superior to intromedullary nail in aspects of completely close reduction，early full weight bearing and early bone healing and alignment.
