Efficacy of dynamic locking screw combined with plate internal fixation for tibial fractures / 中华创伤杂志

ABSTRACT

Objective@#To evaluate the efficacy of dynamic locking screw combined with plate internal fixation for tibial fractures.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 36 patients with tibial fractures (AO 4A-C) admitted to the Second Affiliated Hospital of Army Medical University from March 2017 to March 2018. There were 27 males and nine females, aged 26-71 years [(51.6±14.3)years]. A total of 18 patients were treated with dynamic locking screw combined with locking plate internal fixation (Group A), and another 18 patients received common locking screw combined with locking plate internal fixation (Group B). The operation time, intraoperative bleeding, hospital stay, visual analogue score (VAS), callus growth and fracture healing rate at 4, 8, 12 and 24 weeks after operation were compared between the two groups. At the same time, the complications of internal fixation were evaluated, including screw loosening, screw fracture and steel plate fracture.@*Results@#All the patients were followed up for 8-18 months [(12.2±2.7)months]. There was no significant difference in operation time, intraoperative bleeding, postoperative hospital stay and postoperative VAS between the two groups (P>0.05). At 8 and 12 weeks after operation, the callus growth rate of Group A was 61% and 83% respectively, significantly higher than those of Group B (28% and 50%) (P<0.05). At 8, 12, and 24 weeks after operation, the fracture healing rate of Group A was 17%, 50% and 100% respectively, and those of Group B was 6%, 28% and 89%, showing no significant difference between the two groups (P>0.05). No complications or failure of internal fixation were found during the follow-up.@*Conclusion@#For tibial fractures, the locking plate internal fixation can achieve satisfactory clinical outcome, but the dynamic locking screw system can promote the growth of callus at early stage.