多模式复位联合软骨面下多角度排钉技术固定对复杂胫骨平台骨折的疗效分析  

Efficaly analysis of multimodal reduction combined with subchondral multi-angle row nail technique in the fixation of complex tibial plateau fractures

作　　者：黎清交 范星华 周加平 张观辉 曾森炎 欧阳观保 LI Qingjiao;FAN Xinghua;ZHOU Jiaping;ZHANG Guanhui;ZENG Senyan;OUYANG Guanbao(The Third Department of Bone Traumatology,Xingguo Hospital of Traditional Chinese Medicine,Ganzhou,Jiangxi 342400,China)

机构地区：[1]江西省赣州市兴国县中医院骨伤3科,江西赣州342400

出　　处：《检验医学与临床》2022年第20期2795-2798,共4页Laboratory Medicine and Clinic

基　　金：江西省赣州市指导性科技计划项目(GZ2021ZSF712)。

摘　　要：目的探析多模式复位联合软骨面下多角度排钉技术固定复杂胫骨平台骨折疗效。方法选取该院2019年6月至2021年5月收治的50例复杂胫骨平台骨折患者作为研究对象,按照随机数字表法分成对照组(25例)和观察组(25例)。对照组采用常规钢板内固定治疗,观察组采用常规手术方法钢板内固定+多模式复位联合软骨面下多角度排钉技术固定治疗,比较两组手术相关指标、术后1个月、6个月并发症发生情况、膝关节Rasmuseen影像学评分、膝关节功能评分。结果两组患者术中出血量相比,差异无统计学意义(P>0.05);观察组手术时间较对照组长,术后引流量较对照组少,骨折愈合时间、完全负重时间、住院时间较对照组短,差异有统计学意义(P<0.05)。观察组术后1个月、6个月并发症率较对照组低,差异有统计学意义(P<0.05)。两组术后当天Rasmussen评分相比,差异无统计学意义(P>0.05);术后1个月、3个月、6个月Rasmussen评分均提高,且观察组较对照组高,差异有统计学意义(P<0.05)。两组术后当天HSS评分相比,差异无统计学意义(P>0.05);术后1个月、3个月、6个月HSS评分均提高,且观察组较对照组高,差异有统计学意义(P<0.05)。结论复杂胫骨平台骨折患者,予以多模式复位联合软骨面下多角度排钉技术固定治疗,疗效好,能缩短骨折愈合时间,术后并发症少,为膝关节功能快速康复提供坚强内固定,有助于患者早日康复,推荐使用。Objective To explore the effect of multimodal reduction combined with subchondral multi-angle row nail technique in the fixation of complex tibial plateau fractures.Methods Fifty patients with complex tibial platform fractures treated by Xingguo Hospital of Traditional Chinese Medicine from June 2019 to May 2021 were selected as the research subjects and divided into control group(25 cases)and observation group(25 cases)according to the randomized digital table method.The control group used conventional internal plate fixation,and the observation group fixed the steel plate fixation and multi-angle nail arrangement under the lower cartilage surface.We compared the two groups with surgical related indicators,complications at 1 month and 6 months,Rasmuseen imaging score of knee joint and knee function score.Results(1)There was no significant difference in intraoperative bleeding between the two groups(P>0.05);the operation time of the observation group was longer than that of the control group,the postoperative drainage volume was less,and the fracture healing time,complete weight-bearing time and hospital stay were shorter than those of the control group(P<0.05).(2)The complication rate of the observation group at 1 month and 6 months after operation was lower than that of the control group,and the difference was statistically significant(P<0.05).(3)The Rasmussen score was not significant(P>0.05),increased at 1,3 and 6 months,and the observation group was significant(P<0.05).(4)The HSS scores on the postoperative day between the two groups were not significant(P>0.05);HSS scores increased at 1,3 and 6 months after surgery,and higher than the observation group,significant(P<0.05).Conclusion Patients with complex tibial plateau fractures are treated with multi-mode reduction combined with subchondral multi angle row nail fixation,which has good curative effect,can shorten the time of fracture healing,have less postoperative complications,provide strong internal fixation for the rapid recovery of knee function,and co

关 键 词：复杂胫骨平台骨折 多模式复位 软骨面下多角度排钉技术 

分 类 号：R683.4[医药卫生—骨科学]