Treating low extremity comminuted fracture with biological osteosynthesis / 中国矫形外科杂志

ABSTRACT

[Objective]To treat the low limb comminuted fracture with biological osteosynthesis as a guide in order to decrease damage of periosteal blood supply and increase the bone healing.[Method]For all types of long bone comminuted fracture in low limbs,the operation was taken for keeping connection of bone fragment with periost,indirect reduction through mechanical line,relative stable fixation and there is no need for anatomical reduction.Eighteen cases of intertrochanteric comminuted fractures and 16 cases of low femoral comminuted fractures were treated with DCS.Twenty-six cases of subtrochanteric comminuted fractures and 24 cases of low femoral fractures were fixed with anatomical steel plate in less screws.Twenty-seven cases of femoral shaft comminuted fractures and 31 cases of tibia and fibula comminuted fractures were fixed with compressive plate in less screws.Twenty-six cases of comminuted fractures of femoral shaft and 22 cases of tibia ones were fixed with LC-DCP in less screws.Twenty-five cases of comminuted fractures of femoral shaft and 18 cases of tibia ones were fixed with locking intermedullary nails.One hundred and three cases of comminuted fractures of tibia and fibula were fixed with extra-fixture.Fifty-six cases of comminuted fractures of tibia and fibula were fixed by unilateral multi-purpose external fixing.Twenty-one cases of comminuted fractures of tibia and fibula were fixed by unilateral multi-purpose external fixing with limited screws and plaster.[Result]A total of 413 cases had been treated and followed up within 6～18 months(average 10.5 months).Four hundred and eight cases had bone union and accounted for 98.46% in all cases.One case had nounion and two cases had malunion in femoral fracture.Two cases had delayed union and four cases had nounion in tibia fractures.[Conclusion]It is useful for the bone blood supplying and healing with biological osteosynthesis of reducing bone fracture indirectly and fixing one relatively,especially for comminuted fracture of long bone shaft.