Abstract:

BACKGROUND: Intramedullary nail, plate and external fixation in treatment of comminuted fracture of shaft of femur have their advantages and limitations.
OBJECTIVE: To explore the effects and biomechanical features of bridge combined fixation system in treatment of comminuted fracture of shaft of femur.
METHODS: Bridge combined fixation system was used to treat 45 patients with comminuted fracture of shaft of femur. Functional exercise was performed in early stage of treatment. Therapeutic time, bleeding amount, fracture healing time and the recovery of limb function were evaluated. Biomechanical features of the bridge combined fixation system were analyzed during the treatment of comminuted fracture of shaft of femur, and compared with intramedullary nail and bone plate.
RESULTS AND CONCLUSION: All patients were followed up for 12-24 months, averagely 18 months. The therapeutic time of the bridge combined fixation system was 1.0-2.5 hours, averagely 1.5 hours. Bleeding amount was 100-400 mL, averagely 200 mL. Fracture healing time was 4.0-6.0 months, averagely 4.5 months. After treatment, no severe complications, such as wound infection, fracture disunion, internal fixator loosening or breakage, were observed. Limb function evaluation showed: excellent in 40 cases, good in 2 cases, average in 3 cases, with an excellent and good rate of 93.3%. The bridge combined fixation system was accorded with the feature of fracture biomechanical fixation, and a blend of locking plate, interlocking intramedullary nail and external fixator. For the treatment of femoral fracture, the bridge combined fixation system is operated easily, has wide indication and satisfactory clinical therapeutic effects, and is a new choice for treatment of comminuted fracture of shaft of femur.

Key words: femur, fractures, internal fixation, plate, intramedullary nail, biomechanics