外固定支架辅助固定治疗胫骨平台骨折临床应用价值研究  

Clinical application of external fixation for treatment of tibial plateau fractures

作　　者：方继锋[1] 李广义[1] 高春兵 侯耀鹏 都芳涛[1] Fang Jifeng;Li Guangyi;Gao Chunbing;Hou Yaopeng;Du Fangtao(Department of Orthopaedic Surgery,The Second People’s Hospital of Liaocheng City,Liaocheng,Shandong 252601,China;Operation Unit,The Second People’s Hospital of Liaocheng City,Liaocheng,Shandong 252601,China)

机构地区：[1]聊城市第二人民医院骨创外科,山东聊城252061 [2]聊城市第二人民医院手术室,山东聊城252061

出　　处：《创伤外科杂志》2021年第2期128-131,共4页Journal of Traumatic Surgery

摘　　要：目的探讨胫骨平台骨折(FTP)患者在有限内固定的基础上加用外固定支架进行辅助性固定的效果。方法回顾性分析2016年3月—2019年1月山东省聊城市第二人民医院骨创外科手术治疗的87例开放性SchatzkerⅣ、Ⅴ、Ⅵ型FTP患者,男性58例,女性29例;年龄19~65岁,平均39.0岁;致伤原因:道路交通伤49例,高处坠落伤22例,重物砸伤13例,其他3例。根据固定方式分为外固定支架组49例(有限内固定的基础上联合Taylor外固定支架)和双钢板固定组38例(双侧钢板固定)。对比两组手术时间、手术出血量、骨折愈合时间、膝关节功能Rasmussen评分及手术并发症发生率。结果外固定支架组患者的手术时间(60.0±11.2)min、骨折愈合时间(12.5±1.2)周短于双钢板固定组的(77.8±7.3)min、(13.9±1.6)周(P<0.05),手术出血量(92.5±10.6)mL少于双钢板固定组(118.1±18.3)mL,差异均有统计学意义(P<0.05);术后3个月,外固定支架组的膝关节疼痛(3.38±0.98)分、行走能力(3.38±0.51)分、膝关节活动度(3.38±0.58)分、Rasmussen总分(16.69±1.70)分均高于双钢板固定组[(2.97±0.84)分、(3.01±0.55)分、(2.95±0.62)分、(15.88±1.81)分,P<0.05];外固定支架组手术并发症发生率4.08%与双钢板固定组13.16%比较,差异无统计学意义(P>0.05)。结论采用有限内固定的基础上加用外固定支架治疗FTP患者,手术操作更简单,可减少手术引起的创伤,有利于骨折愈合及术后早期膝关节功能恢复。Objective To investigate the effect of supplementary fixation of external fixation for patients with tibial plateau fractures(FTP)on the basis of limited internal fixation.Methods A retrospective study was conducted in 87 open Schatzker type IV,V,VI FTP patients treated by Department of Orthopedic Surgery in the Second People's Hospital of Liaocheng City,Shandong Province from Mar.2016 to Jan.2019.There were 58 males and 29 females,with an average age of 39.0(range,19-65)years.Among them,49 cases were injured by traffic accidents,22 cases were injured by falling from height,13 cases were injured by heavy objects,and 3 cases were caused by other causes.According to the fixation method,they were divided into external fixation stent group(49 cases,applying Taylor external fixation on the basis of limited internal fixation),and double plate fixation group(38 cases,fixed with bilateral steel plates).The operation time,operative blood loss,fracture healing time,Rasmussen score of knee joint function,and incidence of surgical complications were compared between the two groups.Results The operation time and the fracture healing time in the external fixation group were shorter than those of the double plate fixation group[(60.0±11.2)minutes vs.(77.8±7.3)min and(12.5±1.2)weeks vs.(13.9±1.6)weeks,P<0.05].The surgical blood loss of the external fixation group(92.5±10.6)mL was lower than that of the double plate fixation group(118.1±18.3)mL(P<0.05);at 3 months after operation,the knee joint pain score in the external fixation group was(3.38±0.98)points,walking ability(3.38±0.51)points,knee mobility(3.38±0.58)points,Rasmussen total score(16.69±1.70)points were higher than those of the double plate fixation group[(2.97±0.84)points,(3.01±0.55)points,(2.95±0.62)points,(15.88±1.81)points,P<0.05].The operative complication rate of the external fixation group was 4.08%,which was 13.16%in the double plate fixation group,and the difference was not statistically significant(P>0.05).Conclusion Using external fixation to tr

关 键 词：胫骨平台骨折 有限内固定 外固定支架 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]