微创稳定系统和解剖钢板治疗胫骨近端复杂骨折的对比研究  

A Comparative Study on Less Invasive Stabilization System and Anatomical Plate Fixation of Complicated Proximal Tibial Fractures

作　　者：闫旭[1] 陈新[1] 石忠琪[1] 王佳[1] 

机构地区：[1]天津市天津医院创伤骨科,300211

出　　处：《天津医药》2012年第2期125-128,共4页Tianjin Medical Journal

摘　　要：目的：对比研究微创稳定系统（LISS）和传统解剖钢板治疗胫骨近端复杂骨折的临床效果。方法：2002年7月-2008年12月应用LISS及传统解剖钢板治疗胫骨近端复杂骨折连续性患者58例。解剖钢板组32例，男21例，女11例，平均41．2岁（23-68岁）；骨折按AO／OTA分型A2型5例，A3型9例，C2型16例，C3型2例。LISS钢板组26例，男16例，女10例，平均41．5岁（21-61岁）；骨折按AO／OTA分型A2型4例，A3型7例，C2型13例，C3型2例。所有患者均随访12~18个月，比较2组手术情况、术后并发症及愈合时间，用改良HSS评分来评价术后膝关节功能的改善程度。结果：2组骨折类型、平均年龄及性别分布比较差异无统计学意义（P〉0．05）。手术时间，手术切口，出血量及12个月HSS评分比较，LISS钢板组优于解剖钢板组。解剖钢板组的植骨例数多于LISS钢板组。影像学愈合时间及术后并发症发生总数2组比较差异无统计学意义（P〉0．05）。但LISS钢板组钢板刺激症状较多。结论：LISS及解剖钢板治疗胫骨近端高能量复杂骨折均有较满意效果。LISS还具有手术损伤小，术后恢复快等特点，是治疗胫骨近端复杂骨折的新趋势。Objective： To comparatively study the clinical outcomes of the treatment of complicated proximal tibial fractures by using the less invasive stabilization system （LISS） or the anatomical plate fixation. Methods： From July 2002 to December 2008, 58 consecutive patients with complicated proximal tibial fractures were treated with the LISS or anatomical plate fixation. There were 32 patients in anatomical plate group with 21 male and 11 female, and the average age was 41.2 years （23- 68 years）. Acceding to AO/OTA classification, 5 cases were type A2, 9 cases were A3, 16 cases were C2 and 2 cases were C3. There were 26 patients in LISS plate group with 16 male and 10 female, and the average age was 41.5 years （21-61 years）. Acceding to AO/OTA classification, 4 cases were type A2, 7 cases were A3, 13 cases were C2 and 2 cases were C3. All patients were followed up for 12 to 18 months. Clinical outcomes were assessed by recording the surgical experience, post-operative complications and improvements in knee function as measured by the Hospital for Special Surgery （HSS） scores. Results： There were no significant differences in the fracture type, mean age and gender distribution between two groups. The surgical time, wound size, blood loss and HSS scores of 12 months were significantly better in LISS group than those of anatomical plate group. The number of bone graft was used more frequently in anatomical plate group than that of LISS group. There were no sig- nificant differences in the radiographic healing time and post-operative complications between two groups（P 〉 0.05）. But, there was a higher incidence of symptomatic hardware irritation in LISS group compared to that of anatomical plate group. Conclusion： Both LISS and the anatomical plates have satisfactory outcomes in our study. However, LISS is characterized by the less invasion and more excellent recovery, which is a new trend for the complicated proximal tibial fractures.

关 键 词：胫骨骨折 骨折固定术 内 骨板 外科手术 微创性 微创稳定系统 

分 类 号：R683.42[医药卫生—骨科学]