新型钢板在复杂胫骨平台三柱骨折治疗中的初步应用  

The preliminary application of new plates to treat complex three-column fractures of the tibial plateau

作　　者：林成寿[1] 林旺[1] 郭卫中[1] 许胜贵[1] 苏郁[1] 吴锦清[1] 刘寿坤[1] 

机构地区：[1]福建医科大学附属闽东医院骨科,福建福安355000

出　　处：《创伤与急诊电子杂志》2016年第2期70-76,共7页Journal of Trauma and Emergency(Electronic Version)

基　　金：福建省自然科学基金资助项目(2012J01438)

摘　　要：目的探讨使用新型钢板内固定治疗复杂胫骨平台三柱骨折的临床疗效。方法2011年8月至2015年5月,采用不同钢板固定治疗22例复杂胫骨平台三柱骨折患者。患者随机分为实验组和对照组,各11例。实验组采用新型钢板内固定系统;对照组采用普通钢板。结果术后即刻进行Rasmussen评分:对照组16.0±1.3,实验组16.4±1.2。对照组术后12个月膝关节主动活动度:屈曲度(130.1±3.3)°,伸直度2.1°。实验组术后12个月膝关节主动活动度:屈曲度(130.5±4.1)°,伸直度1.7°。对照组胫骨平台内翻角:术后即刻(87.8±1.5)°、术后12个月(86.5±1.9)°。实验组胫骨平台内翻角:术后即刻(87.6±2.0)°、术后12个月(86.5±1.6)°。对照组胫骨平台后倾角:术后即刻(81.9±3.0)°、术后12个月(81.1±3.5)°。实验组胫骨平台后倾角:术后即刻(81.4±2.6)°、术后12个月(80.5±2.4)°。术后12个月膝关节HSS评分均数:对照组93.2±4.2,实验组94.5±4.5。以上均数对照组和实验组差异无统计学意义。以下两组均数差异有统计学意义。对照组平均手术时间(265.3±48.1)分,实验组平均手术时间(200.9±43.2)分。对照组术中平均出血量(686.4±151.8)ml,实验组术中平均出血量(436.4±120.6)ml。所有患者骨折均获骨性愈合。结论新型钢板治疗复杂胫骨平台三柱骨折疗效确切,相较普通钢板使用更方便。Objective To evaluate the clinical outcomes of using new plates to treat complex three-column fractures of the tibial plateau.Method From August 2011 to May 2015, different plates were used to treat 22 patients with complex three-column fractures of the tibial plateau. The patients were randomly divided into two groups： control group with 11 cases using common plates, experimental group with 11 cases using new plates.Result The mean Rasmussen score of control group immediately after operation was 16.0±1.3 , which was 16.4±1.2 in experimental group. The mean active extension–flexion angles of knee joint 12 months after operation was ： flexion （130.1±3.3）° and extension 2.1° in control group; flexion （130.5±4.1 ）°and extension 1.7° in experimental group.The mean medial proximal tibial angle in control group was（87.8±1.5）° immediately after operation,（86.5±1.9）° 12 months after operation;which in experimental groupwas （87.6±2.0）° immediately after operation,（86.5±1.2）° 12 months after operation. The mean anatomic posterior proximal tibial angle in control group was： （81.9±3.0）°immediately after operation,（81.1±3.5）° 12 months after operation;which in experimental group was： （81.4±2.6）° immediately after operation,（80.5±2.4）° 12 months after operation. The mean HSS （The Hospital for Special Surgery） scores 12 months after operation were 93.2±4.2 in control group and 94.5±4.5 in experimental group. The differences were not statistically significant between the above mean numbers of the two groups .The differences were statistically significant between the following mean numbers of the two groups .The mean operation time of control group was （265.3±48.1）min, which was （200.9±43.2）min in experimental group. The mean intraoperative blood loss in control group was （686.4±151.8）ml, which was （436.4±120.6）ml in experimental group. All fractures healed in the end.Conclusion The new plate is an effective internal fixator to

关 键 词：钢板 胫骨平台 三柱 骨折 

分 类 号：R687.32[医药卫生—骨科学]