A comparative study of titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Junwei ^1,2 , CHEN Lingling ³ , LI Zhaohui ² , NIE Weizhi ² ,  XU Zhanwang ¹

1. Shandong University of Traditional Chinese Medicine, Ji’nan Shandong, 250355, P.R.China;
2. The 1st Department of Trauma Rehabilitation, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China;
3. Orthopaedic Institute, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China;

Corresponding author：

XU Zhanwang, Email: xzw6001@163.com

Keywords：

Galeazzi fracture; bone plate; elastic intramedullary nail; internal fixation; minimally invasive technology

DOI：

10.7507/1002-1892.201705080

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ObjectiveTo explore the effectiveness difference between titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture.MethodsNinety-seven patients of Galeazzi fracture according with the selection criteria were divided into 2 groups by prospective cohort study, who were admitted between January 2012 and November 2015. In the patients, 59 were treated with open reduction and bone plate internal fixation (plate group), and 38 with titanium elastic intramedullary nail internal fixation (minimally invasive group). There was no significant difference in the gender, age, cause of injury, fracture site, type of fracture, and time from injury to operation between 2 groups (P>0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were recorded and compared between 2 groups, and the forearm function was evaluated by Anderson score.ResultsAll the patients were followed up 12-23 months (mean, 17 months). The operation time, intraoperative blood loss, fracture healing time of minimally invasive group were significantly less than those in plate group (P<0.05). There were 1 case of fracture nonunion, 1 case of wound infection in plate group, and 1 case of nail tail slight infection in minimally invasive group, which were all cured after the corresponding treatment. The remaining patients had good fracture healing, and no vascular injury, internal fixation failure, deep infection, or other complications occurred. According to Anderson score at 12 months after operation, the forearm function results were excellent in 46 cases, good in 12 cases, and poor in 1 case, with an excellent and good rate of 98.3% in plate group; and the results were excellent in 26 cases, good in 11 cases, and poor in 1 case, with an excellent and good rate of 97.4% in minimally invasive group; showing no significant difference (χ²=0.10, P=0.75).ConclusionMinimally invasive fixation with titanium elastic nail has such advantages as small damage, quick recovery, no skin scarring, etc. As long as the correct indication is selected, minimally invasive titanium intramedullary nail internal fixation of Galeazzi fractures can also get good effectiveness.

Citation： ZHANG Junwei, CHEN Lingling, LI Zhaohui, NIE Weizhi, XU Zhanwang. A comparative study of titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(4): 406-411. doi: 10.7507/1002-1892.201705080 Copy

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2.	George AV, Lawton JN. Management of complications of forearm fractures. Hand Clin, 2015, 31(2): 217-233.
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8.	Anderson LD, Sisk D, Tooms RE, et al. Compression- plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg (Am), 1975, 57(3): 287-297.
9.	孙家元, 郭家良, 杨宗酉, 等. 2003 年至 2012 年河北医科大学第三医院盖氏骨折的流行病学调查与分析. 中华创伤骨科杂志, 2017, 19(8): 703-707.
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12.	Donati F, Mazzitelli G, Lillo M, et al. Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age. World J Orthop, 2017, 8(2): 156-162.
13.	Huang YC, Renn JH, Tarng YW. The titanium elastic nail serves as an alternative treatment for adult proximal radial shaft fractures: A cohort study. J Orthop Surg Res, 2018, 13(1): 10.
14.	Upadhyay AS, Lil NA. Use of titanium elastic nails in the adult diaphyseal humerus fractures. Malays Orthop J, 2017, 11(2): 53-59.
15.	王亦璁. 骨与关节损伤. 4 版. 北京: 人民卫生出版社, 2007: 904-905.
16.	Kose A, Aydin A, Ezirmik N, et al. A comparison of the treatment results of dpen reduction internal fixation and intramedullary nailing in adult forearm diaphyseal fractures. Ulus Travma Acil Cerrahi Derg, 2017, 23(3): 235-244.
17.	Winckler S, Brug E, Baranowski D. Bundle nailing of forearm fractures: Indications and results. Unfallchirurg, 1991, 94(7): 335-341.
18.	Gadegone WM, Salphale Y, Magarkar D. Percutaneous osteosynthesis of galeazzi fracture-dislocation. Indian J Orthop, 2010, 44(4): 448-452.
19.	徐学鹏, 鲁晓波, 罗雷茗, 等. 弹性髓内钉及股骨锁定加压钢板治疗大龄儿童股骨粗隆下骨折的临床疗效比较. 中国修复重建外科杂志, 2017, 31(10): 1184-1189.
20.	Sinikumpu JJ, Serlo W. The shaft fractures of the radius and ulna in children: Current concepts. J Pediatr Orthop B, 2015, 24(3): 200-206.
21.	Antabak A, Luetic T, Ivo S, et al. Treatment outcomes of both-bone diaphyseal paediatric forearm fractures. Injury, 2013, 44 Suppl 3: S11-15.
22.	Saka G, Saglam N, Kurtulmus T, et al. Treatment of isolated diaphyseal fractures of the radius with an intramedullary nail in adults. Eur J Orthop Surg Traumatol, 2014, 24(7): 1085-1093.
23.	张峻玮, 聂伟志, 陈玲玲, 等. 髓内钉与接骨板治疗锁骨中段骨折的前瞻性随机对照研究. 中华创伤骨科杂志, 2016, 18(7): 558-563.

1. Giannoulis FS, Sotereanos DG. Galeazzi fractures and dislocations. Hand Clin, 2007, 23(2): 153-163, v.
2. George AV, Lawton JN. Management of complications of forearm fractures. Hand Clin, 2015, 31(2): 217-233.
3. Fayaz HC, Jupiter JB. Galeazzi fractures: our modified classification and treatment regimen. Handchir Mikrochir Plast Chir, 2014, 46(1): 31-33.
4. Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Orthop Surg, 2011, 19(10): 623-633.
5. Takemoto R, Sugi M, Immerman I, et al. Ulnar variance as a predictor of persistent instability following galeazzi fracture-dislocations. J Orthop Traumatol, 2014, 15(1): 41-46.
6. 龙江, 袁志, 李岩, 等. 9 例盖氏骨折术后骨不连合并下尺桡关节炎的疗效分析. 现代生物医学进展, 2017, 17(6): 1060-1062, 1098.
7. Gwinn DE, O’Toole RV, Eglseder WA. Early motion protocol for select galeazzi fractures after radial shaft fixation. J Surg Orthop Adv, 2010, 19(2): 104-108.
8. Anderson LD, Sisk D, Tooms RE, et al. Compression- plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg (Am), 1975, 57(3): 287-297.
9. 孙家元, 郭家良, 杨宗酉, 等. 2003 年至 2012 年河北医科大学第三医院盖氏骨折的流行病学调查与分析. 中华创伤骨科杂志, 2017, 19(8): 703-707.
10. Ding BTK, Pillay K, Sechachalam S. Radial shaft fracture obliquity as a predictor of distal radioulnar joint instability. J Hand Surg (Eur Vol), 2018. [Epub ahead of print].
11. Yohe NJ, De Tolla J, Kaye MB, et al. Irreducible galeazzi fracture-dislocations. Hand (N Y), 2017. [Epub ahead of print].
12. Donati F, Mazzitelli G, Lillo M, et al. Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age. World J Orthop, 2017, 8(2): 156-162.
13. Huang YC, Renn JH, Tarng YW. The titanium elastic nail serves as an alternative treatment for adult proximal radial shaft fractures: A cohort study. J Orthop Surg Res, 2018, 13(1): 10.
14. Upadhyay AS, Lil NA. Use of titanium elastic nails in the adult diaphyseal humerus fractures. Malays Orthop J, 2017, 11(2): 53-59.
15. 王亦璁. 骨与关节损伤. 4 版. 北京: 人民卫生出版社, 2007: 904-905.
16. Kose A, Aydin A, Ezirmik N, et al. A comparison of the treatment results of dpen reduction internal fixation and intramedullary nailing in adult forearm diaphyseal fractures. Ulus Travma Acil Cerrahi Derg, 2017, 23(3): 235-244.
17. Winckler S, Brug E, Baranowski D. Bundle nailing of forearm fractures: Indications and results. Unfallchirurg, 1991, 94(7): 335-341.
18. Gadegone WM, Salphale Y, Magarkar D. Percutaneous osteosynthesis of galeazzi fracture-dislocation. Indian J Orthop, 2010, 44(4): 448-452.
19. 徐学鹏, 鲁晓波, 罗雷茗, 等. 弹性髓内钉及股骨锁定加压钢板治疗大龄儿童股骨粗隆下骨折的临床疗效比较. 中国修复重建外科杂志, 2017, 31(10): 1184-1189.
20. Sinikumpu JJ, Serlo W. The shaft fractures of the radius and ulna in children: Current concepts. J Pediatr Orthop B, 2015, 24(3): 200-206.
21. Antabak A, Luetic T, Ivo S, et al. Treatment outcomes of both-bone diaphyseal paediatric forearm fractures. Injury, 2013, 44 Suppl 3: S11-15.
22. Saka G, Saglam N, Kurtulmus T, et al. Treatment of isolated diaphyseal fractures of the radius with an intramedullary nail in adults. Eur J Orthop Surg Traumatol, 2014, 24(7): 1085-1093.
23. 张峻玮, 聂伟志, 陈玲玲, 等. 髓内钉与接骨板治疗锁骨中段骨折的前瞻性随机对照研究. 中华创伤骨科杂志, 2016, 18(7): 558-563.

Chinese Journal of Reparative and Reconstructive Surgery

A comparative study of titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture

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