双切口双钢板内固定在胫骨平台骨折患者中应用及对肢体功能的影响  

Application of Double-incision and Double-plate Internal Fixation in Patients with Tibial Plateau Fractures and Its Influence on Limb Function

作　　者：吴越 WU Yue(Wuxue Traditional Chinese Medicine Hospital,Wuxue 435400,China)

机构地区：[1]武穴市中医医院,湖北武穴435400

出　　处：《中外医学研究》2021年第26期134-137,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨双切口双钢板内固定在胫骨平台骨折患者中的效果及对肢体功能的影响。方法:选择2017年7月-2019年2月胫骨平台骨折患者124例为对象,随机数字表法分为两组,各62例。对照组采用锁定钢板内固定治疗,观察组采用双切口双钢板内固定治疗,术后3个月评估患者效果并完成12个月随访,比较两组手术指标、胫骨平台内翻角(TPA)、内侧后倾角(PA)、Rasmussen膝关节功能评分、术后并发症。结果:观察组负重及骨折愈合时间、膝关节开始功能锻炼时间均早于对照组(P<0.05);观察组手术后3个月TPA、PA角度低于对照组(P<0.05);疼痛、稳定性、活动范围及行走能力评分高于对照组(P<0.05);两组术后切口感染、膝关节不稳、针道感染及固定物断裂发生率差异无统计意义(P>0.05);观察组术后膝关节僵直发生率低于对照组(P<0.05)。结论:双切口双钢板内固定用于胫骨平台骨折患者中手术创伤较小,能改善患者TPA、PA,提高患者膝关节功能,有助于降低术后并发症发生率,值得推广应用。Objective:To investigate the effect of double-incision and double-plate internal fixation in patients with tibial plateau fractures and its influence on limb function.Method:A total of 124 patients with tibial plateau fractures from July 2017 to February 2019 were selected as subjects,and they were divided into two groups by random number table,with 62 cases in each group.The control group was treated with locking plate internal fixation,and the observation group was treated with double-incision and double-plate internal fixation.The patient’s effect was evaluated 3 months after the operation and a 12-month follow-up was completed.The two groups were compared with surgical indicators,tibial plateau varus angle(TPA),medial posterior angle(PA),Rasmussen knee function score,postoperative complications.Result:The weight-bearing,fracture healing time and the knee joint functional exercise time of the observation group were earlier than those of the control group(P<0.05);the observation group’s TPA and PA angles 3 months after surgery were lower than those of the control group(P<0.05).The scores of pain,stability,range of motion and walking ability of the observation group were higher than those of the control group(P<0.05);the incidence of postoperative wound infection,knee instability,needle infection,and fixation breakage in the two groups was not statistically significant(P>0.05).The incidence of postoperative knee stiffness in the observation group was lower than that in the control group(P<0.05).Conclusion:Double-incision and double-plate internal fixation for tibial plateau fractures has less surgical trauma,can improve patients’TPA and PA,improve patients’knee joint function,and help reduce postoperative complications.It is worthy of popularization and application.

关 键 词：双切口双钢板内固定 胫骨平台骨折 锁定钢板内固定 肢体功能 Rasmussen膝关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]