胫前减张切口结合锁定加压钢板治疗老年胫腓骨远端骨折的病例对照研究  

Tension reduced incision through anterior tibial approach combined with locking compression plate fixation for treatment of elderly patients with distal tibiofibular fractures

作　　者：黄海 张喜才 史伯玮 潘华 许丽江 左海强 

机构地区：[1]阳泉煤业集团有限公司总医院骨科,山西阳泉045000

出　　处：《中国骨伤》2014年第6期453-457,共5页China Journal of Orthopaedics and Traumatology

基　　金：山西省卫生厅科研项目(编号:201202052)~~

摘　　要：目的：探讨内固定治疗老年胫腓骨远端骨折的有效手术入路方式。方法：2008年8月至2012年10月,采用胫前减张切口结合锁定加压钢板（LCP）内固定治疗老年胫腓骨远端骨折患者175例,男112例,女63例;年龄60~83岁,平均71.3岁。其中采用胫前减张切口结合LCP治疗89例,男62例,女27例;年龄（71.8±6.4）岁。采用胫骨远端内侧小切口经皮LCP治疗86例,男58例,女28例;年龄（70.3±6.7）岁。治疗后对两组患者的消肿时间、手术时间、术中失血量、住院时间、骨折愈合时间、术后并发症及术后12个月患肢AOFAS评分进行比较。结果：胫前减张切口结合LCP治疗组与胫骨远端内侧小切口经皮LCP治疗组的术前消肿治疗时间分别为（5.6±1.3）d、（9.7±2.1）d;骨折愈合时间分别为（4.2±1.4）个月、（5.4±1.9）个月;术后并发症发生分别为3例、10例,两组比较差异均有统计学意义（P〈0.05）。术后12个月随访时,胫前减张切口结合LCP治疗组AOFAS评分为89.0±9.7,胫骨远端内侧小切口经皮LCP治疗组87.9±9.4,两组比较差异无统计学意义（P〉0.05）。结论：胫前减张切口结合LCP内固定治疗老年胫腓骨远端骨折,有利于骨折愈合,可降低术后并发症,疗效满意。Objective： To explore effective approaches of treating elderly patients with distal tibiofibular fractures. Methods：From August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate （LCP） through anterior tibial. There were 112 males and 63 females with an average of 71.3 （ranged 60 to 83） years old. Of them, 89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of （71.8±6.4） years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of （70.3±6.7） years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation. Results：Swelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was （5.6＋1.3） and （9.7＋2.1） days,healing time was （4.2＋1.4） and （5.4＋1.9） months,and complications were found 3 in tension reduced incision and 10 in distak tibia] incision respectively;and all data shown statistically significant differences between two groups （P〈0.05）. At 12 months after operation,AOFAS score was 89.0＋9.7,87.9_＋9.4;and there was no statistically significant difference between two groups （P〉 0.05）. Conclnsion ：Tension reduced incision through anterior tibial combined with locking compression plate fixation in treat- ing elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

关 键 词：胫骨 腓骨 骨折 老年人 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学]