外侧锁定钢板结合内侧切口辅助复位治疗部分复杂胫骨平台骨折的疗效研究  

Study on efficacy of lateral locking plate combined with medial incision assisted reduction for the treatment of partially complex tibial plateau fractures

作　　者：郑朝文 高旭 ZHENG Chao-wen;GAO Xu(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院,221000

出　　处：《中国实用医药》2022年第27期82-86,共5页China Practical Medicine

摘　　要：目的 分析外侧锁定钢板结合内侧切口辅助复位与内外侧双钢板治疗部分复杂胫骨平台骨折的疗效。方法 85例SchatzkerⅤ型、Ⅵ型胫骨平台骨折中内侧骨折块较大且较完整患者,依据随机数字表法分为对照组(42例)和观察组(43例)。观察组行外侧锁定钢板切开复位内固定术结合内侧切口辅助复位治疗,对照组行内侧支撑钢板切开复位内固定术结合外侧锁定钢板内固定治疗。对比两组患者手术相关指标(手术时间、术后引流量、膝关节开始锻炼时间、患肢完全负重时间、骨折愈合时间),术后12个月膝关节功能恢复效果,术前及术后12个月功能性步行量表(FAC)、简式Fugl-Meyer运动功能评定量表(FMA)评分,术后即刻及术后12个月胫骨平台内翻角(TPA)、内侧后倾角(PA),并发症发生情况。结果 观察组患者手术时间(121.20±12.60)min、骨折愈合时间(95.90±8.62)d、患肢完全负重时间(103.00±11.13)d短于对照组的(142.20±12.35)min、(112.30±15.64)d、(121.60±9.86)d,术后引流量(72.20±21.14)ml少于对照组的(111.50±21.94)ml,差异均有统计学意义(P<0.05);两组患者膝关节开始锻炼时间比较差异无统计学意义(P>0.05)。术前,对照组患者FAC、FMA评分分别为(1.84±0.21)、(14.36±2.38)分,术后12个月分别为(6.20±0.92)、(20.90±1.91)分;术前,观察组患者FAC、FMA评分分别为(1.87±0.25)、(14.23±2.41)分,术后12个月分别为(6.10±0.99)、(21.30±2.41)分。术前、术后12个月,两组患者FAC、FMA评分组间比较差异均无统计学意义(P>0.05);术后12个月,两组患者FAC、FMA评分均高于本组术前,差异具有统计学意义(P<0.05)。术后12个月,两组患者膝关节功能恢复优良率比较差异无统计学意义(P>0.05)。术后即刻、术后12个月,两组患者TPA、PA组内及组间比较差异均无统计学意义(P>0.05)。观察组患者术后12个月内并发症总发生率为6.98%,低于对照组的26.19%,差异具有统计学Objective To analyze the efficacy of lateral locking plate combined with medial incision assisted reduction for the treatment of partially complex tibial plateau fractures. Methods A total of 85 cases of Schatzkertype Ⅴ and Ⅵ tibial plateau fractures patients with relatively large medial fracture blocks were divided into control group(42 cases) and observation group(43 cases) according to the random numerical table.The observation group was treated with lateral locking plate open reduction and internal fixation and medial incision assisted reduction, while the control group was treated with medial supporting plate open reduction and internal fixation and lateral locking plate internal fixation. Both groups were compared in terms of surgical related indexes(operation time, postoperative drainage volume, starting time of knee-joint exercise, full weightbearing time of affected limb, fracture healing time), the recovery effect of knee-joint function 12 months after surgery, the functional ambulation category scale(FAC) score and Fugl-Meyer assessment scale(FMA) score before and 12 months after surgery, and the tibial plateau angle(TPA) and posterior angle(PA) immediately after surgery and 12 months after surgery, and occurrence of complications. Results The operation time(121.20±12.60) min, fracture healing time(95.90±8.62) d, and full weight-bearing time(103.00±11.13) d in the observation group were shorter than(142.20±12.35) min,(112.30±15.64) d, and(121.60±9.86) d in the control group;the postoperative drainage volume(72.20±21.14) ml in the observation group was less than(111.50±21.94) ml in the control group;the differences were statistically significant(P<0.05). There was no statistically significant difference in starting time of knee-joint exercise between the two groups(P>0.05). In the control group,the FAC and FMA scores of patients were(1.84±0.21) and(14.36±2.38) points before surgery, and those were(6.20±0.92) and(20.90±1.91) points at 12 months after surgery;in the observation group, the

关 键 词：复杂胫骨平台骨折 内侧切口 外侧锁定钢板 切开复位 关节功能 

分 类 号：R687.3[医药卫生—骨科学]