改良膝关节撑开器联合微创经皮钢板固定治疗复杂胫骨平台骨折  

Modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures

作　　者：吴财 罗田 曾庆虎 彭成忠[1] 廖涛[1] 王乐乐[1] 曾钊[1] Wu Cai;Luo Tian;Zeng Qinghu;Peng Chengzhong;Liao Tao;Wang Lele;Zeng Zhao(Department of Orthopedics,Xiangdong Hospital Affiliated to Hunan Normal University,Liling 412200,Hunan Province,China)

机构地区：[1]湖南师范大学附属湘东医院骨科,湖南省醴陵市412200

出　　处：《中国组织工程研究》2020年第27期4305-4309,共5页Chinese Journal of Tissue Engineering Research

基　　金：湖南省教育厅一般基金项目(19C1161),项目负责人:彭成忠。

摘　　要：背景:有研究利用长骨撑开器辅助治疗不稳定型胫骨平台骨折取得了满意的疗效,但其使用长骨撑开器的安全性不高,易造成软组织损伤。目的:对比改良膝关节撑开器联合微创经皮钢板内固定与传统切开复位钢板内固定治疗复杂胫骨平台骨折的临床疗效。方法:纳入2016年1月至2018年1月湖南师范大学附属湘东医院收治的71例复杂胫骨平台骨折患者,其中男48例,女23例,试验组34例接受改良膝关节撑开器联合微创经皮钢板内固定治疗,对照组37例接受传统切开复位钢板内固定治疗。对比两组切口长度、手术时间、术中出血量、住院时间、骨折愈合时间及术后并发症发生率,术后1个月及末次随访时进行膝关节HSS评分。试验获得湖南师范大学附属湘东医院伦理审查委员会批准。结果与结论:(1)试验组手术时间、术中出血量、切口长度与住院时间均少于对照组(P<0.05),两组骨折愈合时间比较差异无显著性意义(P>0.05);(2)试验组术后出现关节僵硬1例与创伤性关节炎1例,对照组术后出现感染1例、关节僵硬5例、创伤性关节炎1例与内固定松动1例,试验组并发症发生率少于对照组(P<0.05);(3)71例患者获得10-14个月随访,试验组术后1个月的膝关节功能HSS评分情况明显优于对照组(P<0.05),两组末次随访的膝关节功能HSS评分情况比较差异无显著性意义(P>0.05);(4)结果表明与传统切开复位内固定相比,改良膝关节撑开器联合微创经皮钢板内固定治疗复杂胫骨平台骨折可提高手术效率、减少手术创伤、降低术后并发症的发生率,缩短患者住院时间。BACKGROUND: Studies have shown that the adjuvant use of long bone distraction device for unstable tibial plateau fractures achieved satisfactory results, but the safety of its use of long bone distraction device is not high, and the device could easily lead to soft tissue damage. OBJECTIVE: To compare the clinical efficacy of modified knee joint spreader combined with minimally invasive percutaneous plate internal fixation and traditional incision reduction plate internal fixation for the treatment of complex tibial plateau fractures. METHODS: A total of 71 patients with complicated tibial plateau fractures admitted to Xiangdong Hospital Affiliated to Hunan Normal University from January 2016 to January 2018 were included, including 48 males and 23 females. The 34 patients in the experimental group received modified knee spreaders combined with minimally invasive percutaneous plate internal fixation treatment. The 37 patients in the control group received traditional open reduction and plate internal fixation. The incision length, operation time, intraoperative blood loss, hospital stay, the time of fracture healing and the incidence of postoperative complications were compared between the two groups. Knee HSS scores were assessed at 1 month and at the last follow-up. The trial was approved by the Ethics Committee of Xiangdong Hospital Affiliated to Hunan Normal University. RESULTS AND CONCLUSION:(1) The operation time, intraoperative blood loss, incision length, and hospital stay were shorter in the experimental group than in the control group(P < 0.05). There was no significant difference in fracture healing time between the two groups(P > 0.05).(2) One case of joint stiffness and one case of traumatic arthritis were found in the experimental group. One case of postoperative infection, five cases of joint stiffness, one case of traumatic arthritis and one case of loosening of the internal fixation were found in the control group. The incidence of complications in the experimental group was less than that in the

关 键 词：复杂胫骨平台骨折 改良撑开器 微创经皮钢板内固定 MIPPO技术 手术治疗 内固定 膝关节功能 并发症 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]