双侧支持和单侧支持钢板联合外固定架在复杂胫骨平台骨折中的应用效果对比分析  

Comparative analysis of application effect of bilateral and unilateral support plate internal fixation combined with external fixator in complex tibial plateau fractures

作　　者：周占锋 吴靖宇 ZHOU Zhanfeng;WU Jingyu(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Henan Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州市中心医院,河南郑州450000

出　　处：《包头医学院学报》2020年第8期19-23,共5页Journal of Baotou Medical College

摘　　要：目的:对比双侧支持和单侧支持钢板联合外固定架在复杂胫骨平台骨折中的应用效果。方法:选择2017年4月至2019年4月就诊的92例复杂胫骨平台骨折患者作为研究对象,随机分为观察组48例和对照组44例,对照组行双侧支持钢板内固定,观察组行单侧支持钢板联合外固定架,比较围术期情况、视觉模拟疼痛评分(VAS)、医院膝关节评分量表(HSS)、关节功能优良率、术后并发症情况,全部患者在术后6个月进行复查。结果:观察组切口长度、手术时间、住院时间、骨折愈合时间均短于对照组,术中出血量少于对照组(P<0.05);术后3 d、5 d、8 d的VAS评分,观察组均低于对照组(P<0.05);6个月复查结果显示,观察组HSS评分高于对照组(P<0.05);观察组关节功能优良率高于对照组(P<0.05),观察组关节功能受限、感染、骨不连的总发生率低于对照组(P<0.05)。结论:与双侧支持相比,单侧支持钢板联合外固定架对复杂胫骨平台骨折疗效更加显著,具有创伤小、术后疼痛轻微、恢复快等优点,可帮助患者早期恢复关节功能,值得临床推广应用。Objective:To study the comparative analysis of application effect of bilateral and unilateral support plate internal fixation combined with external fixator in complex tibial plateau fractures.Methods:92 patients with complex tibial plateau fractures in our hospital from April 2017 to April 2019 were selected to study.they were divided into observation group 48 cases and control group 44 cases by random number table method.the control group was treated with bilateral support plate internal fixation,while the observation group was treated with unilateral support plate internal fixation combined with external fixator.The perioperative conditions,visual analogue pain score(VAS),hospital knee score scale(HSS),excellent and good rate of joint function and complications were compared between the two groups.all patients were reexamined 6 months after operation.Results:the incision length,operation time,hospitalization time and fracture healing time of the observation group were shorter than those in the control group,and the amount of bleeding during operation was less than those in the control group.(P<0.05),there was no significant difference in intraoperative bleeding and postoperative drainage between the two groups(P>0.05);the visual analogue pain score scores of the observation group on the 3st,5rd and 8th day after operation were lower than those of the control group(P<0.05);6 month review showed that the Hospital knee Joint Score Scale score of the observation group was higher than that of the control group(P<0.05);the excellent and good rate of joint function in observation group was higher than that in control group(P<0.05);the total incidence of joint function limitation,infection and nonunion in the observation group was lower than that in the control group.(P<0.05).Conclusion:Compared with bilateral support,unilateral support plate internal fixation combined with external fixator is more effective in treating complex tibial plateau fractures,it has the advantages of less trauma,less pain and faster recovery

关 键 词：复杂胫骨平台骨折 双侧支持内固定钢板 单侧支持内固定钢板 外固定架 术后并发症 

分 类 号：R687.3[医药卫生—骨科学]