Yao Liwei, Mao Haijiao, Dong Wenwei, Wu Zeting, Liu Qing
Department of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, 315010, Zhejiang province, China.
Department of General Practice, The First Affiliated Hospital of Ningbo University, Ningbo, 315010, Zhejiang province, China.
Chin J Traumatol. 2025 Mar;28(2):113-117. doi: 10.1016/j.cjtee.2024.10.004. Epub 2025 Jan 23.
This study aims to investigate the efficacy of novel distraction support (DS) in intramedullary nailing treatment for tibial shaft fracture.
The random controlled trial included adult patients with tibial shaft fractures who were treated with intramedullary nailing at the trauma center between July 2013 and December 2018. Participants were randomly assigned to either control group (n=43) or DS group (n=42) based on whether DS was used during the operation. All surgical procedures were conducted by a single, experienced surgeon. Parameters such as hospital stay, blood loss, operative time, infection, delayed union, and malalignment were recorded for assessment. Shapiro-Wilk test was used to assess normality, and the F test was adopted to measure variance homogeneity. Continuous variables were presented as mean±standard deviation and compared via independent samples t-tests. Categorical variables are expressed as percentages. The Pearson's Chi-squared or Fisher's exact test was used for categorical variables n (%). Two-sided p<0.05 indicated statistical significance.
A total of 85 participants were enrolled in the study. All cases achieved acceptable reduction. The operative time was significantly shorter in the DS group than in control group ((75.3±10.5) min vs. (90.4±15.5) min, p<0.001). Additionally, the DS group showed lesser blood loss ((60.1±27.2) mL vs. (85.4±25.4) mL, p<0.001). No significant differences were observed between the 2 groups in terms of hospital stay ((9.4±2.7) days vs. (10.2±3.1) days, p=0.370), infection (3 (7.1%) vs. 2 (4.7%), p=0.978), delayed union (2 (4.8%) vs. 5 (11.6%), p=0.450), and malalignment (3 (7.1%) vs. 5 (11.6%), p=0.713).
The use of DS in intramedullary nailing surgery is effective. The application of this DS system may represent a valuable addition to future clinical practice.
本研究旨在探讨新型撑开支撑（DS）在胫骨干骨折髓内钉治疗中的疗效。
这项随机对照试验纳入了2013年7月至2018年12月在创伤中心接受髓内钉治疗的成年胫骨干骨折患者。根据手术中是否使用DS，将参与者随机分为对照组（n = 43）或DS组（n = 42）。所有手术均由一位经验丰富的外科医生进行。记录住院时间、失血量、手术时间、感染、骨延迟愈合和畸形等参数进行评估。采用Shapiro-Wilk检验评估正态性，采用F检验测量方差齐性。连续变量以均值±标准差表示，并通过独立样本t检验进行比较。分类变量以百分比表示。分类变量n（%）采用Pearson卡方检验或Fisher精确检验。双侧p<0.05表示具有统计学意义。
本研究共纳入85名参与者。所有病例均获得了可接受的复位。DS组的手术时间明显短于对照组（（75.3±10.5）分钟对（90.4±15.5）分钟，p<0.001）。此外，DS组的失血量较少（（60.1±27.2）毫升对（85.4±25.4）毫升，p<0.001）。两组在住院时间（（9.4±2.7）天对（10.2±3.1）天，p = 0.370）、感染（3例（7.1%）对2例（4.7%），p = 0.978）、骨延迟愈合（2例（4.8%）对5例（11.6%），p = 0.450）和畸形（3例（7.1%）对5例（11.6%），p = 0.713）方面未观察到显著差异。
在髓内钉手术中使用DS是有效的。这种DS系统的应用可能为未来的临床实践增添有价值的内容。
