To Study the Effect of Locking Intramedullary Nails in the Treatment of Nonunion after Lower Extremity Trauma Fractures and the Influence of Postoperative Complications

GAO Xiang; AI Chengbin; DUAN Fei; YIN Yichang; DENG Chunmei; YANG Zhengcai; LIU Zunyu

doi:10.14033/j.cnki.cfmr.2025.035.014

Abstract：Objective:To observe the effect of using locking intramedullary nails as the main method in the treatment of patients with nonunion after lower extremity trauma fractures and its impact on postoperative complications.Method:128 patients with femoral and tibial fractures admitted to the Chuxiong Yi Autonomous Prefecture Traditional Chinese Medicine Hospital from January 2017 to December 2024 were selected.The selected cases were randomly divided into two groups by the random number table method,with 64 cases in each group.Among them,the cases that received compression plate internal fixation were classified as the control group,while the remaining cases received internal fixation with locking intramedullary nails and were classified as the observation group.The comprehensive treatment outcomes of different groups were compared.Result:Compared with the excellent and good rate of 85.94%in the control group and 96.88%in the observation group,the difference was statistically significant(P<0.05).In terms of the operation time and postoperative hospital stay,the observation group was shorter than the control group,and the difference was statistically significant(P<0.05).In terms of intraoperative blood loss and postoperative drainage volume,compared with the control group,the observation group had less,and the difference was statistically significant(P<0.05).After surgical treatment,the levels of propeptide of tyoe I procollagen(PINP),bone alkaline phosphatase(BALP),Bone Gla Protein(BGP),etc.in the observation group were all higher than those in the control group,and the differences were statistically significant(P<0.05).The total probability of complications such as incision infection,poor healing,joint stiffness and loosening of internal fixators in the observation group was 3.13%,which was lower than 15.63%in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant difference in the preoperative exercise,living and knee joint function scores between the two groups(P>0.05).After surgical treatment,compared with the control group,the scores of each index in the observation group increased,and the differences were statistically significant(P<0.05).Conclusion:For patients with nonunion after lower extremity trauma fractures,internal fixation with locking intramedullary nails not only improves the excellent and good rate of clinical treatment,but also enhances perioperative indicators,increases bone metabolism levels,reduces the risk of complications,thereby promoting the improvement of patients'motor function,quality of life and knee joint function,and improving prognosis.