锁定加压钛合金板治疗青少年胫骨远端三平面骨折效果观察  

Clinical efficiency of locking compression plate in treatment of three plane fractures of distal tibia in adolescents

作　　者：马智林[1] 冯文方 陈欣志[1] 段晓伟[3] 牛静 张永涛[1] 乔国勇[1] 刘志平 MA Zhilin;FENG Wenfang;CHEN Xinzhi(Department of Osteology,Affiliated Hospital of Hebei Engineering University,Hebei,Handan 056002,China;不详)

机构地区：[1]河北工程大学附属医院骨二科,河北省邯郸市056002 [2]河北工程大学附属医院超声科,河北省邯郸市056002 [3]河北省邯郸市中心医院院前急救

出　　处：《河北医药》2021年第24期3759-3761,3765,共4页Hebei Medical Journal

基　　金：邯郸市科学技术研究与发展计划项目(编号:1723208068-6)。

摘　　要：目的观察锁定加压钛合金板治疗青少年胫骨远端三平面骨折的临床效果。方法选取2018年1月至2019年7月收治的24例青少年胫骨远端三平面骨折患者,根据不同术式将其纳入A组与B组,每组12例,A组应用切开复位解剖板内固定术治疗,B组应用锁定加压钛合金板内固定术治疗,对比2组的术中指标(手术时间、出血量)、术后指标(肢体肿胀程度、疼痛程度、下地活动时间、骨折愈合时间)、并发症(骨筋膜室综合征、皮瓣坏死、内固定物松动断裂、创伤性关节炎、关节僵硬、感染)、踝关节功能恢复情况(AOFAS评分与踝关节活动度)以及总体疗效。结果B组的手术时间短于A组,出血量少于A组(P<0.05);B组的肢体肿胀程度评分、疼痛程度评分均低于A组,下地活动时间与骨折愈合时间均短于A组(P<0.05);B组的并发症发生率低于A组(P<0.05);B组的AOFAS评分高于A组,跖屈、背伸的活动度均大于A组,外翻、内翻的活动度均小于A组(P<0.05);B组的优良率高于A组(P<0.05)。结论锁定加压钛合金板治疗青少年胫骨远端三平面骨折的临床效果确切,具有手术时间短、出血量少、术后肢体肿胀与疼痛轻微,下地活动与骨折愈合时间短、并发症发生率低等优势,值得推行。Objective To investigate the clinical efficiency of locking compression plate in treatment of three plane fractures of distal tibia in adolescents,and to explore an effective operation method,so as to improve the curative effect and promote the early recovery of patients.Methods A total of 24 adolescent patients with triplane distal tibial fractures were enrolled in the study.According to different surgical methods,they were divided into group A and group B,with 12 cases in each group.The patients in group A were treated by open reduction and internal fixation with locking compression plate,however,the patients in group B were treated by locking compression plate internal fixation.The postoperative indexes(limb swelling degree,pain degree,ambulation time,fracture healing time),complications(osteofascial compartment syndrome,flap necrosis,internal fixation loosening and fracture,traumatic arthritis,joint stiffness,infection),ankle joint function recovery(AOFAS score and ankle range of motion)as wel as total effective rate were observed and compared between the two groups.Results The operation time and bleeding volume as well as the incidence of complications in group B were significantly less than those in control group(P<0.05),and the scores of limb swelling degree and pain degree in group B were significantly lower than those in control group(P<0.05),however,the AOFAS scores in group B were significantly higher than those in control group(P<0.05).In addition activity time and healing time of fracture in group B were significantly shorter than those in control group(P<0.05),and the good/excellent rates in group B were significantly higher than those in control group(P<0.05).Conclusion The clinical effects of locking compression plate in treatment of distal tibial three plane fracture in adolescents are satisfactory,with the advantages of short operation time,less blood loss,slight postoperative limb swelling and pain,shorter time of ground activity and fracture healing,which has certain clinical significance.

关 键 词：锁定加压钛合金板 青少年 胫骨远端三平面骨折 手术指标 并发症 踝关节功能 

分 类 号：R683.423[医药卫生—骨科学]