双钢板联合入路内固定治疗SchatzkerⅤ型胫骨平台骨折的效果及对关节面塌陷程度的影响  

Effect of Double Plate Combined with Approach Internal Fixation in the Treatment of Schatzker TypeⅤTibial Plateau Fracture and Its Effect on the Degree of Articular Surface Collapse

作　　者：王刚[1] 甘雨[2] WANG Gang;GAN Yu(Shenyang Orthopedic Hospital,Liaoning Province,Shenyang 110044,China;不详)

机构地区：[1]沈阳市骨科医院,辽宁沈阳110044 [2]辽宁省中医药研究院

出　　处：《中国医学创新》2021年第36期39-43,共5页Medical Innovation of China

基　　金：辽宁省自然科学基金项目(20170540555)。

摘　　要：目的:探讨双钢板联合入路内固定治疗SchatzkerⅤ型胫骨平台骨折的效果及对关节面塌陷程度的影响。方法:选择2018年11月-2019年10月沈阳市骨科医院收治的72例SchatzkerⅤ型胫骨平台骨折患者,按随机数字表法将其分为对照组和试验组,各36例。对照组采用单钢板加空心螺钉固定治疗,试验组采用膝关节前外侧联合后内侧入路方式下双钢板内固定治疗。比较两组手术时间、术中出血量、愈合状况、患肢负重时间及术后12个月膝关节功能Rasmussen评分和并发症发生情况;并于术后3、12个月测量胫骨平台内翻角(TPA)与后倾角(PSA)度数,评估关节面塌陷程度。结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05);试验组骨折愈合时间、患肢负重时间均显著短于对照组(P<0.05)。术后12个月,试验组膝关节功能恢复优良率为91.67%,显著高于对照组的75.00%,并发症发生率(5.56%)明显低于对照组(22.22%),差异均有统计学意义(P<0.05)。术后3个月,两组TPA、PSA度数比较,差异均无统计学意义(P>0.05);术后12个月,试验组TPA、PSA度数均低于对照组(P<0.05)。结论:针对SchatzkerⅤ型胫骨平台骨折,采用前外侧+后内侧联合入路双钢板内固定术能减轻膝关节面塌陷程度,促进膝关节功能的恢复,减少并发症的发生。Objective:To investigate the effect of double plate combined with approach internal fixation in the treatment of Schatzker type V tibial plateau fractures and its effect on the degree of articular surface collapse.Method:A total of 72 patients with Schatzker type V tibial plateau fractures were selected in Shenyang Orthopaedic Hospital from November 2018 to October 2019,they were divided into control group and experimental group,with 36 cases in each group.The control group was treated with single plate combined with compressive hollow screws internal fixation,and the experimental group was treated with double plate internal fixation through anterolateral combined posteromedial approach of knee joint.The operation time,intra-operative bleeding,healing status,weight bearing time of the affected limb,knee function Rasmussen score 12 months after operation and complications were compared between the two groups;the tibial plateau-tibial shaft angle(TPA)and posterior slope angle(PSA)were measured at 3 and 12 months after operation to evaluate the degree of articular surface collapse.Result:There were no significant differences between the two groups in operation time,intra-operative bleeding(P>0.05);the healing time of fracture and weight bearing time of the affected limb of the experimental group were significantly shorter than those of the control group(P<0.05).At 12 months after operation,the excellent and good rate of knee joint function recovery in the experimental group was 91.67%,which was significantly higher than 75.00%in the control group,the incidence of complications(5.56%)was significantly lower than 22.22%in the control group,the differences were statistically significant(P<0.05).At 3 months after operation,there were no significant differences in TPA and PSA between the two groups(P>0.05);at 12 months after operation,the degree of TPA and PSA in the experimental group were lower than those in the control group(P<0.05).Conclusion:For Schatzker typeⅤtibial plateau fractures,the combined anterolateral an

关 键 词：胫骨平台骨折 双钢板联合入路内固定 SchatzkerⅤ型 关节面塌陷 

分 类 号：R687.3[医药卫生—骨科学]