RESUMO
BACKGROUND:Intramedul ary nail fixation has more advantages in open fractures compared with the locking compression plate, such as the dual functions of lock and compression, highly protecting the blood supply in fracture end, less tissue trauma, firm elastic fixation and low infection rate. OBJECTIVE:To investigate the clinical efficacy and biomechanical properties of tibial intramedul ary nail and locking compression plate in treatment of open tibial fractures by stages. METHODS:Total y 100 patients with open tibial fractures who received treatment at the Department of Orthopedics, Jiaozhou Central Hospital of Qingdao Affiliated to Weifang Medical Col ege from January 2012 to January 2014 were enrol ed. Patients were divided into tibial intramedul ary nail group (n=57) and locking compression plate group (n=43) according to the surgical procedures using randomized control ed method. Ten corpses models of open tibial fractures provided by Jiaozhou Central Hospital of Qingdao Affiliated to Weifang Medical Col ege were selected, and then randomly divided into 2 groups. Three-point bending test, axial compression test and torsional strength test were conducted after the fixation with tibial intramedul ary nail and locking compression plate. RESULTS AND CONCLUSION:The operative time and per-operative blood loss of patients in the tibial intramedul ary nail group was significantly less than those in the locking compression plate group (P<0.05). There were no significant differences in wound infection, fixtures loosening, not healing and other complications after fixation between these two groups. There were no incision infection in these two groups. The specimens bending test offset, axial compression experiments offset and torsion test torsion angle in tibial intramedul ary nail group were significantly less than those in the locking compression plate group (P<0.05). These results demonstrate that tibial intramedul ary nail and locking compression plate for treatment of open tibial fractures by stages can achieve the desired therapeutic effect, however, the biomechanics of tibial intramedul ary nail is more stable, and more in line with the biomechanical properties of human body, with the advantages of firm fixation, doing exercises in early stage and smal stress shielding. Choosing the appropriate materials according to patient’s symptoms and fracture location during treatment can improve the curative effect.