不同内固定术式治疗复杂胫骨平台骨折的疗效对比  

Comparison of the efficacy of different internal fixation methods in the treatment of complex tibial plateau fractures

作　　者：张兴州[1] 徐鹏[1] 李冰[1] 吴俊琪 ZHANG Xing-zhou;XU Peng;LI Bing(Department of Orthopedics,Wujin Hospital of Traditional Chinese Medicine,Changzhou 213161,China)

机构地区：[1]江苏省常州市武进中医医院骨伤科,213161

出　　处：《中国实用医药》2022年第19期17-20,共4页China Practical Medicine

摘　　要：目的研究应用不同内固定手术治疗复杂胫骨平台骨折的临床效果。方法45例复杂胫骨平台骨折患者,依据抽样法分为对照组(22例)与观察组(23例)。对照组行单侧锁定钢板内固定,观察组行膝关节内外侧双切口双钢板复位内固定。比较两组疗效,手术指标,治疗前后的美国纽约特种外科医院膝关节(HSS)评分、内翻角(TPA)、后倾角(PA),并发症发生率。结果观察组的优良率为95.65%,高于对照组的72.73%,差异有统计学意义(P<0.05)。两组手术时间、术中出血量、愈合时间比较,差异无统计学意义(P>0.05);观察组住院时间(13.25±2.78)d短于对照组的(15.86±5.02)d,差异有统计学意义(P<0.05)。治疗后,观察组的HSS评分、PA分别为(85.33±9.47)分、(8.46±2.03)°,均高于对照组的(80.07±7.62)分、(6.98±2.48)°;TPA为(3.14±0.13)°,小于对照组的(3.66±0.47)°,差异有统计学意义(P<0.05)。观察组的并发症发生率为4.35%,低于对照组的27.27%,差异有统计学意义(P<0.05)。结论应用膝关节内外侧双切口双钢板复位内固定和单侧锁定钢板内固定治疗复杂胫骨平台骨折效果均显著,但前者疗效更佳,并发症发生率更低。Objective To study the clinical effect of different internal fixation methods in the treatment of complex tibial plateau fractures.Methods A total of 45 patients with complex tibial plateau fractures were divided into control group(22 cases)and observation group(23 cases)according to sampling method.The control group was treated with unilateral locking plate internal fixation,and the observation group was treated with internal fixation of medial and lateral knee joint with double incision and double plate reduction.The clinical efficacy,surgical index,hospital for special surgery knee score(HSS),tibial plateau angle(TPA)and posterior tibial angle(PA)before and after treatment,and complication rate were compared between the two groups.Results The excellent and good rate of the observation group was 95.65%,which was higher than 72.73%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in operation time,intraoperative blood loss and healing time between the two groups(P>0.05).The hospitalization time(13.25±2.78)d in the observation group was shorter than(15.86±5.02)d in the control group,and the difference was statistically significant(P<0.05).After treatment,the HSS score and PA of the observation group were(85.33±9.47)points and(8.46±2.03)°,which were higher than(80.07±7.62)points and(6.98±2.48)°of the control group;the TPA(3.14±0.13)°of the observation group was less than(3.66±0.47)°of the control group;and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 4.35%,which was lower than 27.27%in the control group,and the difference was statistically significant(P<0.05).Conclusion Both internal fixation of medial and lateral knee joint with double incision and double plate reduction and unilateral locking plate internal fixation have significant effect in the treatment of complex tibial plateau fractures,but the former has better efficacy and lower incidence of compli

关 键 词：复杂胫骨平台骨折 膝关节内外侧双切口双钢板复位内固定 单侧锁定钢板内固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]