切开复位内固定结合羟基磷灰石支撑自体骨植骨钢板治疗SchatzkerⅡ型胫骨平台骨折的效果与安全性  

Efficacy and Safety of Open Reduction and Internal Fixation Combined with Hydroxyapatite-supported Autologous Bone Graft Plate in the Treatment of Schatzker TypeⅡTibial Plateau Fractures

作　　者：崔万勇[1] 白冰[2] CUI Wan-yong;BAI Bing(The First Department of Orthopedics,Chengde Central Hospital,Chengde,Hebei 067000,China;the Second Department of Orthopedics,Chengde Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]承德市中心医院骨一病区,河北承德067000 [2]承德市中心医院骨二病区,河北承德067000

出　　处：《临床误诊误治》2022年第11期84-88,共5页Clinical Misdiagnosis & Mistherapy

基　　金：承德市科学技术研究与发展计划项目(202102A019)。

摘　　要：目的探究切开复位内固定结合羟基磷灰石(HA)支撑自体骨植骨钢板治疗SchatzkerⅡ型胫骨平台骨折(TPF)的效果与安全性。方法收集2019年10月—2021年10月100例SchatzkerⅡ型TPF的临床资料,根据手术方案不同分为研究组和对照组,每组50例。研究组采用切开复位内固定结合HA支撑自体骨植骨钢板治疗,对照组采用常规切开复位钢板内固定治疗。比较2组手术相关指标、手术疗效和并发症发生情况,比较手术前后膝关节活动度、美国膝关节协会评分标准(KSS)评分、美国纽约特种外科医院(HSS)评分、疼痛数字等级量表(NRS)评分以及血清神经生长因子(NGF)、Ⅰ型前胶原氨基端前肽(PⅠNP)、碱性磷酸酶(ALP)水平。结果研究组骨折愈合时间较对照组短,手术疗效优良率较对照组高(P<0.05)。术后3、6个月,2组膝关节伸直度、屈曲度均较术前增大,且研究组较对照组大(P<0.05)。术后3、6个月,2组KSS、HSS评分均较术前升高,NRS评分均较术前降低;且研究组KSS、HSS评分较对照组高,NRS评分较对照组低(P<0.05)。术后3个月,2组血清NGF、PⅠNP、ALP水平均较术前升高,且研究组较对照组高(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论切开复位内固定结合HA支撑自体骨植骨钢板治疗SchatzkerⅡ型TPF的效果良好,能进一步改善膝关节功能,减少并发症,促进患者康复。Objective To investigate the efficacy and safety of open reduction and internal fixation combined with Hydroxyapatite(HA)-supported autologous bone grafting plate in the treatment of Schatzker typeⅡtibial plateau fracture(TPF).Methods Clinical data of 100 patients with Schatzker typeⅡTPF from October 2019 to October 2021 were collected and divided into research group(n=50)and control group(n=50)according to different surgical protocols.The research group was treated with open reduction and internal fixation combined with HA supported autogenous bone graft plate,while the control group was treated with conventional open reduction and internal fixation with plate.The operation-related indicators,surgical efficacy and complications of the two groups were compared.Knee range of motion(ROM),American Knee Society Score(KSS),New York Hospital for Special Surgery(HSS)score,Numerical Pain Rating Scale(NRS)score,and serum nerve growth factor(NGF),typeⅠprocollagen amino terminal propeptide(PⅠNP),alkaline phosphatase(ALP)levels were compared before and after surgery.Results The fracture healing time of the research group was shorter than that of the control group,and the excellent and good rate of surgical effect was higher than that of the control group(P<0.05).At 3 and 6 months after surgery,the knee extension and flexion of the 2 groups were increased,which were higher in the research group than in the control group(P<0.05).At 3 and 6 months after surgery,KSS and HSS scores were higher than those before surgery,while NRS scores were lower than those before surgery;KSS and HSS scores of the research group were higher than those of the control group,while NRS scores of the research group were lower than those of the control group(P<0.05).At 3 months after surgery,the serum levels of NGF,PⅠNP and ALP in the two groups were higher than those before surgery,and higher in the research group than in the control group(P<0.05).The incidence of complications in the research group was lower than that in the control group(P

关 键 词：胫骨平台骨折 切开复位钢板内固定 羟基磷灰石 自体骨植骨 手术时间 膝关节活动度 美国膝关节协会评分标准 神经生长因子 

分 类 号：R683.42[医药卫生—骨科学]