双切口双钢板法与单切口单钢板法治疗复杂胫骨平台骨折的效果比较  

Comparison of the clinical effects between double-incision & double-plate technique and single-incision & single-plate on the treatment of complex tibial plateau fractures

作　　者：韦巍[1] 蓝春祎 韦铭铭[1] 

机构地区：[1]河池市第三人民医院四肢创伤手外科,广西547000

出　　处：《中国临床新医学》2016年第7期632-635,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨复杂胫骨平台骨折的治疗策略。方法选取2008-01~2014-09收入河池市第三人民医院骨科,采用三柱分型理论指导进行手术的46例复杂胫骨平台骨折患者为研究对象,根据手术方法不同分为观察组和对照组各23例。对照组采用膝前外侧单切口单钢板法治疗,观察组采用膝内外侧双切口双钢板法治疗,观察两组骨折愈合时间、术后治疗效果、并发症发生情况等。结果观察组骨折愈合时间为（122.12±47.25）d,短于对照组的（187.31±86.84）d,差异有统计学意义（P〈0.05）;观察组内固定失败率为4.35%,低于对照组的26.09%,骨折再塌陷率为0.00%,低于对照组的21.74%,关节面恢复较差率为0.00%,低于对照组的17.39%,差异无统计学意义（P〉0.05）;观察组术后1年Merchant评分总得分为（89.7±5.6）分,高于对照组的（82.6±4.3）分,差异有统计学意义（P〈0.05）。结论根据三柱分型理论指导,复杂胫骨平台骨折患者给予膝内外侧双切口双钢板治疗,能缩短骨折愈合时间,降低固定失败、骨折再塌陷等情况的发生率,使患者受损肢体功能早日康复,值得临床应用推广。Objective To explore the treatment strategy of complex tibial plateau fractures. Methods Forty-six patients with complex tibial plateau fractures undergoing surgeries guided by the three column classification theory from January 2008 to September 2014 were collected as the research subjects and were divided into the observation group and the control group,with 23 cases in each group according to the different operation methods. The single-incision plate method of anterolateral knees was applied to treat the patients in the control group and the medial and lateral knees double-incision double-steel plate method was applied to treat the patients in the observation group. The fracture healing time,curative effects and complications were compared between the two groups. Results The fracture healing time of the observation group（ 122. 12 ± 47. 25） days,was significantly shorter than that of the control group（ 187. 31 ± 86. 84） days,P〈0. 05; The internal fixation failure rate of the observation group（ 4. 35%） was significantly less than that of the control group（ 26. 09%）. The fracture recollapse rate of the observation group（ 0. 00%） was significantly less than that of the control group（ 21. 74%）. The difference rate of joint surface of the control group（ 0. 00%）,was significantly less than that of the control group（ 17. 39%）,P〉0. 05. The total Merchant scores of the observation group（ 89. 7 ± 5. 6） were significantly higher than those of the control group（ 82. 6 ±4. 3）,P〈0. 05. Conclusion Patients with complex tibial plateau fractures are subject to medial and lateral doubleincision or double-steel plate according to the guidance of three-column theory which can shorten the healing time of fracture,reduce the incidences of fixation failure and fracture re-collapse.

关 键 词：复杂胫骨平台骨折 三柱分型 治疗策略 

分 类 号：R68[医药卫生—骨科学]