膝内外侧双切口双钢板内固定术治疗复杂胫骨平台骨折的效果观察  

Effect of medial and lateral double-plating fixation of knee on patients with complex fracture of tibial plateau

作　　者：轩中勋 杨东辉 陈庭瑞 陈琦 Xuan Zhongxun;Yang Donghui;Chen Tingrui;Chen Qi(Department of Traumatic Orthopedics,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]河南省驻马店市中心医院创伤骨科,463000

出　　处：《中国实用医刊》2021年第19期12-15,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析膝内外侧双切口双钢板内固定术治疗复杂胫骨平台骨折的效果。方法抽取2019年1月至2020年4月驻马店市中心医院收治的复杂胫骨平台骨折患者78例,按随机数字表法分为观察组与对照组,每组39例。对照组采用膝前正中直切口双钢板固定术,观察组采用膝内外侧双切口双钢板内固定术。比较两组膝关节功能优良率、围术期情况、Rasmussen评分(关节面塌陷、成角畸形、平台增宽)、胫骨平台角度[内侧后倾角(PA)、内翻角(TPA)]、Fugl-Meyer运动功能测评法(FMA)评分。结果观察组膝关节功能优良率为89.74%(35/39),高于对照组的71.79%(28/39),P<0.05。观察组手术时间长于对照组,术中出血量少于对照组,负重下地时间、骨折端愈合时间短于对照组(P<0.05)。术后6个月、1年,观察组关节面塌陷、成角畸形、平台增宽评分均高于对照组(P均<0.05);术后1年,观察组PA、TPA低于对照组(P<0.05);术后6个月、1年,观察组FMA评分高于对照组(P<0.05)。结论膝内外侧双切口双钢板内固定术治疗复杂胫骨平台骨折,可加快术后恢复和骨折愈合,促进胫骨平台角度和膝关节功能恢复,并可提高下肢功能。Objective To analyze the effects of medial and lateral double-plating fixation of knee on patients with complex fracture of the tibial plateau.Methods A total of 78 patients with complex fracture of the tibial plateau treated in Zhumadian Central Hospital from January 2019 to April 2020 were selected and divided into observation group and control group according to random number table method,with 39 cases in each group.The control group was treated by anteriorly medial incision double-plating fixation,while the observation group was treated by medial and lateral double-plating fixation.The excellent and good rate of knee function,perioperative conditions,Rasmussen score(articular surface collapse,angulation deformity,platform widening),tibial plateau Angle,including medial posterior slope angle(PA),tibial plateau angle(TPA),and Fugl-Meyer motor function assessment(FMA)score were compared between the two groups.Results The excellent and good rate of knee joint function in observation group(89.74%,35/39)was higher than that in control group(71.79%,28/39),P<0.05.Compared with the control group,the observation group had longer operation time,less intraoperative blood loss,shorter loading time and shorter fracture healing time(P<0.05).Six months and 1 year after surgery,the scores of articular surface collapse,angulation deformity and platform widening in observation group were higher than those in control group(all P<0.05).One year after operation,the PA and TPA of observation group were lower than those of control group(P<0.05).Six months and 1 year after surgery,the FMA score of observation group was higher than that of control group(P<0.05).Conclusions Medial and lateral double-plating fixation in the treatment of complex fracture of the tibial plateau with can accelerate the postoperative recovery and fracture healing,promote the recovery of tibial plateau angle and knee joint function,and improve the function of lower limbs.

关 键 词：胫骨平台骨折 膝内外侧双切口双钢板内固定术 胫骨平台角度 膝关节功能 Rasmussen评分 下肢功能 

分 类 号：R687.3[医药卫生—骨科学]