[Case-control study on different fixation methods for the treatment of tibial fractures in 96 patients]

To compare the therapeutic effects of limited excision and locking plate fixation, interlocking intramedullary nailing and external fixation in treating tibial fractures.

From May 2007 to May 2011, 96 patients with tibial fractures were divided into three groups (Group A, Group B and Group C) and were treated with three kind of fixations including limited excision and locking plate fixation (36 cases in Group A, including 24 males and 12 females), interlocking intramedullary mailing (38 cases in Group B, including 22 males and 16 females) and external fixation (22 cases in Group C, including 12 males and 10 females). Operative time, healing time, weight-bearing time and complications were observed. Johner-Wruhs scoring was used to evaluate the function of lower limbs.

All patients were followed up from 3 months to 30 months with an average of 13 months. In Group A, the operative time was (85.01 +/- 12.2) minutes; the healing time was (143.0 + 12.3) days; the weight-bearing time was (114.3 +/- 12.2) days; Complications occured in 3 patients. According to Johner-Wruhs scoring, the results were rated as excellent in 21 cases, good in 12 cases, moderate in 2 cases, and poor in 1 case; In Group B, the operative time was (90.0 +/- 14.6) minutes; the healing time was (132.0 +/- 14.6) days; the weight-bearing time was (46.0 +/- 12.2) days; Three patients occurred complications. According to Johner-Wruhs scoring,the results were rated as excellent in 24 cases, good in 11 cases, moderate in 2 cases, and poor in 1 case. In Group C, the operative time was (70.0 +/- 10.2) minutes; the healing time was (121.0 +/- 13.5) days; the weight-bearing time was (108.2 +/- 8.9) days; Two patients underwent complications. According to Johner-Wruhs scoring, the results were rated as excellent in 16 cases, good in 5 cases, moderate in 0 case, and poor in 1 case. There were no significant significance among three groups in operative time, healing time, complications and the lower limbs function recovered (P > 0.05). But weight-bearing time in interlocking intramedullary nailing was better than in limited excision and locking plate fixation and external fixation (P < 0.05).

Different fixation methods have different advantages. Limited excision,closed reduction with locking plate fixation is an ideal method to treat the tibial fracture.