锁定钢板内固定术治疗复杂胫骨平台骨折的疗效及技巧探讨  

Efficacy of internal fixation with locking plates in treatment of complex tibial plateau fracture and its skills

作　　者：赵阳[1] 刘宇波[1] 

机构地区：[1]辽宁省沈阳市骨科医院骨伤一病房,辽宁沈阳110044

出　　处：《实用临床医药杂志》2016年第17期78-80,84,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11527787)

摘　　要：目的探讨锁定钢板内固定治疗复杂胫骨平台骨折的效果及技巧分析。方法 98例复杂性胫骨平台骨折随机分为A组和B组,各49例,A组采用锁定钢板内固定治疗,B组采用双切口双钢板内固定术式,记录2组患者手术耗时、切口长度、术中出血量、骨折愈合时间及术后膝关节功能恢复的优良率。结果 98例患者术后随访平均(5.1±0.5)个月,A组患者骨折愈合时间显著短于B组(P<0.05),且A组下地负重锻炼的时间显著早于B组(P<0.05),A组患者膝关节功能恢复的优良率为87.8%(43/49),略高于B组的83.8%(41/49),但差异无统计学意义(P>0.05)。结论相比于双切口双钢板内固定术式,在治疗复杂胫骨平台骨折时锁定钢板内固定更利于骨折端的愈合,缩短骨折愈合时间,在实际操作中需把握好手术时机及螺钉的放置方法。Objective To explore the efficacy of internal fixation with locking plates in treatment of complex tibial plateau fracture and to analyze the skills. Methods A total of 98 patients with complex tibial plateau fracture were randomly divided into group A and group B, with 49 cases for each group. Group A was treated with internal fixation with locking plates while group B with in- ternal fixation with bi-incision bi-plates. Surgical duration, incision length, intra-operative hemor- rhagic volume, healing time of bone fracture and excellent rate of postoperative knee function recovery were recorded in both groups. Results The average postoperative follow-up time of the 98 patients was （ 5. 1 ± 0.5 ） months. Group A was evidently shorter in healing time of bone fracture （ P 〈 0.05 ） , and earlier in the time of off-bed bear-load exercises than control group （ P 〈 0.05 ）. The ex- cellent rate of postoperative knee function recovery was 87.8% （43/49） in group A, which was slightly higher than the 83.8% （41/49） in group B, but there was no significant difference （P 〉 0.05 ）. Conclusion Internal fixation with locking plates is better than internal fixation with hi-inci- sion hi-plates in improving the healing of bone fracture end, and can shorten the healing time of bone fracture. However, the surgical time and the placement of screws should be well mastered in practical operation.

关 键 词：复杂性胫骨平台骨折 锁定钢板 双切口双钢板 SCHATZKER分型 

分 类 号：R683[医药卫生—骨科学]