Application of the Distraction Support in Intramedullary Nailing Treatment for Tibial Shaft Fracture: A Randomized Controlled Study

Abstract

Purpose The aim of this study is to investigate the effectiveness of using a new distraction support in intramedullary nailing treatment for tibial shaft fracture.Methods: Patients at the trauma center who underwent the treatment for tibial shaft fractures from July 2013 to December 2018 were enrolled. The patients were randomized in control group(n=43) and distraction support(SD) group(n=42). All operations were performed by the same senior surgeon. The hospital day, blood loss, operative time, infect rate, delayed union rate and malalignment rate(p=0.68) were obtained for the evaluation.Results: 85 participants were recruited and all cases were achieved the acceptable reduction. The operative time was significantly shorter for DS group than control group (75.3 vs.90.4 p<0.001). Blood loss was significantly lower in the DS group compared to the control group(60.1vs.85.4 p=0.003) . There were no obvious difference about infect rate(p=0.98), delay union(p=0.45), hospital days(p=0.37) and malalignment rate(p=0.68) between the two groups.Conclusion: Distraction support was effective in intramedullary nailing surgery. The application of distraction support may be a useful method in our future work.

Would your intraoperative results differ if you were a four-handed orthopedist in intramedullary nail surgery for tibial fractures?

“…In the study of Yao et al a distraction supporting device was used in tibial fracture. The mean duration of operation was 75.3±10.5 (minutes), the amount of bleeding was 60.1±27.2(ml), infection rate was 7%, deep vein thrombosis was 0% and delayed union rate was 4% [18]. The multiplanar fracture redactor was used in the study by Zhao et al The mean duration of surgery was 91.2±26.1 minutes; the mean amount of bleeding was 95.0±58.3ml; infection rate was 0%; deep vein thrombosis was 1%; and delayed union rate was 0% [19].…”