Treatment of tibia-fibula fracture with intramedul
Following experimental study for many years, the First Hospital of Daqing municipality, used the intramedullary nail specially for tibial fracture in 986 cases of fracture of the tibia in recent years and the same treatment was carried out in other 6 hospitals in the same city. Excellent results were obtained in 97 % of the cases. This hospital, in cooperation with 6 hospitals, used the intramedullary nails specially designed for the tibia treated 986 cases of fractures of the tibia from September 1997 to March 2001, among them 978 cases had fresh fractures (534 open fractures) and 8 cases old fractures. The fractures occurred in the middle segment of the tibia in 839 cases, lower segment in 131 cases, upper segment in 12 cases, double segmental fracture in 4 cases. The patterns of the fracture consisted of the transverse type in 337 cases, oblique in 223 cases, spiral in 118 cases, comminuted in 308 cases. The follow-up period lasted for 6 months to 4 years with an average of 3 years and 6 months. The patients in this series were allowed ambulatory with support as early as 3 days following surgery, and as late as 28 days with an average of 20 days. Callus formation was evident 3 weeks postoperatively, and the average bony union occurred in an average of 3 months. The functions of the knee and ankle joints were normal without limping. Nonunion was seen in 3 cases (0/3 %). The intramedullary nail was removed already in 728 cases, and the excellent rate of treatment was 97 %(according to the 1997 standard of Johner and Wrnh).
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The results of clinical practice indicated that this kind of intramedullary nail for the tibia was of a high strength which conform with the modern principle of fracture management. The patients were allowed early ambulation which exerted a continuous compression stimulation in between the fractured segments to promote fracture healing; the surgical approach was minimal giving adequate exposure and no incision was needed at the site of the fracture; the fracture was closely reduced with internal fixation. In the cases of open fractures, the reduction was done following debridement. The manipulation was simple and for the dexterity hands the procedure can be finished within 15 minutes, with much shortening of the time of wound exposure and thus reduced chance of infection. During the operation, in order to help bone healing, detachment of the periosteum at the fractured segments was not necessary except there were loose bony fragments attached and steel wires were used to tie them up. The nails were removed easily through a small incision just below the knee joint., 百拇医药
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The results of clinical practice indicated that this kind of intramedullary nail for the tibia was of a high strength which conform with the modern principle of fracture management. The patients were allowed early ambulation which exerted a continuous compression stimulation in between the fractured segments to promote fracture healing; the surgical approach was minimal giving adequate exposure and no incision was needed at the site of the fracture; the fracture was closely reduced with internal fixation. In the cases of open fractures, the reduction was done following debridement. The manipulation was simple and for the dexterity hands the procedure can be finished within 15 minutes, with much shortening of the time of wound exposure and thus reduced chance of infection. During the operation, in order to help bone healing, detachment of the periosteum at the fractured segments was not necessary except there were loose bony fragments attached and steel wires were used to tie them up. The nails were removed easily through a small incision just below the knee joint., 百拇医药