锁定钢板加植骨固定联合早期功能锻炼在胫骨平台骨折患者治疗中的应用研究  

Application of locking plate and bone graft fixation combined with early functional exercise in the treatment of patients with tibial plateau fractures

作　　者：刘雄业 王荣生[1] 石裕明[1] LIU Xiong-ye;WANG Rong-sheng;SHI Yu-ming(Department of Orthopaedies,Xinyi People＇s Hospital,Guangdong Provinee,Xinyi 525300,China)

机构地区：[1]广东省信宜市人民医院骨科,广东信宜525300

出　　处：《中国当代医药》2018年第23期102-105,共4页China Modern Medicine

摘　　要：目的探讨锁定钢板加植骨固定联合早期功能锻炼应用于胫骨平台骨折患者治疗的临床效果。方法选取2014年1月~2017年3月我院收治的98例胫骨平台骨折患者作为研究对象,均给予锁定钢板加植骨固定联合早期功能锻炼,观察术后并发症、完全负重时间、骨折愈合时间、膝关节评分标准(HSS)评分情况,对术后不同时间的平台后倾角(PA)、胫骨平台内翻角(TPA)度数进行比较。结果本组98例患者不存在严重皮肤坏死,且未发生钢板松动、伤口感染等情况。随访1年,患者完全负重时间为90~110 d,平均(98.69±3.69)d;骨折愈合时间87~112 d,平均(96.98±3.32)d。术后3个月的HSS评分为(72.12±10.16)分,术后6个月为(77.45±9.81)分,术后12个月为(84.65±11.20)分。术后12个月优良率为95.92%,明显高于术后3、6个月的76.53%、83.67%,差异有统计学意义(P<0.05)。结论锁定钢板加植骨固定联合早期功能锻炼在胫骨平台骨折患者治疗中有显著效果,可有效促进患者骨折骨关节功能恢复,无并发症,对提高术后患者的生活质量具有积极意义。Objective To investigate the clinical effect of locking plate and bone graft fixation combined with early functional exercise in the treatment of patients with tibial plateau fractures. Methods A total of 98 patients with tibial plateau fractures treated in our hospital from January 2014 to March 2017 were selected as study subjects. They were all provided with locking plate and bone graft fixation combined with early functional exercise in order to observe postoperative complications, complete loading time, healing time of bone fracture, knee joint scoring standard（HSS） scores.Meanwhile, the degrees of PA and TPA at different time after surgery were compared. Results Among 98 patients, there was no severe skin necrosis, loosening of steel plates or wound infection. After one year of follow-up, the patient′ s complete loading time was 90-110 d, average（98.69 ±3.69） d. The fracture healing time was 87-112 d, average（96.98±3.32） d. The HSS scores after 3, 6 and 12 months operation were（72.12±10.16） points,（77.45±9.81） points,and（84.65±11.20） points in turn. The excellent and good rate was 95.92% after 12 months operation, significantly higher than 76.53% and 83.67% after 3 and 6 months operation respectively, with statistical significance（P〈0.05）. Conclusion Locking plate and bone graft fixation combined with early functional exercise have significant effect in the treatment of patients with tibial plateau fractures, which can effectively promote fracture and joint function recovery without complications, and paly positive significance for the improvement of postoperative quality of life.

关 键 词：锁定钢板加植骨固定 早期功能锻炼 胫骨平台骨折 

分 类 号：R687.3[医药卫生—骨科学]