Study on treatment of distal tibial comminuted fractures and patients' responses based on biomechanical properties

Distal tibial comminuted fractures present great management challenges due to difficulties in reduction and fixation. By combining the merits of calcaneal traction and conventional external fixators, the adjustable reverse traction frame has emerged as an effective therapeutic approach. This study evaluated 303 patients with distal tibial comminuted fractures treated at Zhongjiang County People's Hospital, comprising 153 patients in the experimental group and 150 in the control group. Following treatment with adjustable reverse traction frame and conventional frame, respectively, in-vivo biomechanical indicators—including alignment reduction and joint torsion angle—were compared and analyzed between the groups. Furthermore, because general anesthesia frequently induces postoperative nausea and vomiting—which causes a sudden, sharp increase in wound tensile stress and subsequent wound dehiscence—targeted interventions to prevent vomiting were implemented in this research. Although not statistically significant, the adjustable reverse-traction frame achieved clinically superior outcomes compared with the conventional frame, with notable improvements in swelling reduction, alignment, and joint torsion angle correction. Additionally, for patients under general anesthesia, traditional Chinese medicine pack intervention demonstrated superior antiemetic efficacy compared to routine care, effectively reducing vomiting-induced wound laceration caused by elevated tensile stress.