锁定钢板内固定术治疗胫骨平台骨折的疗效及中、远期随访观察  

Clinical effect of locking plate internal fixation on tibial plateau fractures and medium and long-term follow-up study

作　　者：王文拴 葛建中 Wang Wenshuan, Ge Jianzhong(1.The Second People＇ s Hospital of Yangquan, Yangquan 045011, China; 2.the First People＇ s Hospital of Yangquan, Yangquan 045000, Chin)

机构地区：[1]山西省阳泉市第二人民医院,045011 [2]山西省阳泉市第一人民医院,045000

出　　处：《中国实用医刊》2018年第2期31-34,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨锁定钢板内固定术治疗胫骨平台骨折患者的疗效及中、远期随访情况.方法 选取医院84例胫骨平台骨折患者,依据不同手术方案分组,每组42例.观察组行锁定钢板内固定术治疗,对照组予以普通钢板内固定术治疗.统计观察两组手术相关指标、手术效果及术后并发症发生情况,术后随访3年,比较两组术后0.5年、1年、3年膝关节活动度及胫骨平台后倾角（PA）、内翻角（TPA）.结果 与对照组比较,观察组术后留院观察、完全负重、骨折愈合时间均较短,差异有统计学意义（P〈0.05）;两组手术优良率比较,观察组[85.71％（36/42）]高于对照组[66.67％（28/42）],差异有统计学意义（P〈0.05）;观察组术后并发症发生率[28.57％（12/42）]与对照组[38.10％（16/42）]比较,差异未见统计学意义（P〉0.05）;两组术后0.5年、1年、3年膝关节活动度、PA、TPA比较,差异均未见统计学意义（P〈0.05）.结论 对胫骨平台骨折患者予以锁定钢板内固定术治疗,固定效果良好,术后恢复快,中、远期膝关节活动度良好,且不会造成胫骨平台后倾、内翻角度丢失,手术效果显著,安全性高,值得临床应用.Objective To investigate the efficacy of locking plate internal fixation on tibial plat-eau fractures and the medium and long-term follow-up. Methods Eighty-four patients with tibial plateau fractures were selected and divided into two groups according to surgical scheme,with 42 cases in each group. The patients in observation group were treated by locking plate internal fixation,and the patients in control group were treated by common plate fixation. The operation related indicators,surgical results and postoperative complications were observed and followed up for 3 years. The knee mobility,tibial plat-eau tilt angle （PA）and varus angle （TPA）were compared between the two groups after six months,1 year and 3 years. Results After the operation,the hospital observation,full weight bearing and fracture healing time of the patients in observation group were shorter than those of the control group,the differ-ences were significant （P 〈 0. 05）. The excellent and good rate of operation in the observation group was 85. 71% （36 / 42）,which was higher than that of the control group [66. 67%（28 / 42）],the difference was significant（P 〈 0. 05）. The postoperative complication rate in the observation group was 28. 57%（12 / 42）,and it was 38. 10% （16 / 42）in the control group,but the difference was not significant （P 〉0. 05）. There was no significant difference in knee mobility,PA or TPA between the two groups after 0. 5 year,1 year and 3 years （P 〈 0. 05）. Conclusions Locking plate fixation has good fixation effect on tib-ial plateau fracture,by which patients recover quickly and the knee joint movement is good in the middle and long term,and it will not cause the tilting of the tibial plateau and the loss of varus angle. The opera-tion effect is remarkable and the safety is high. It is worthy of clinical application.

关 键 词：锁定钢板内固定术 胫骨平台骨折 骨折愈合时间 

分 类 号：R687.3[医药卫生—骨科学]