下肢骨折牵引复位装置辅助复位钢板内固定治疗SchatzkerⅥ型胫骨平台骨折的临床康复疗效观察  

Clinical on clinical rehabilitation effect of traction reduction device for lower limb fracture assisted by reduction and internal fixation with steel plate in the treatment of Schatzker type VI tibial plateau fractures

作　　者：杨伟欣[1] 李冬梅[1] 李宝明[2] 杨佐明[1] 张瑞红[1] 程艳辉 YangWeixin;Li Dongmei;Li Baoming;Yang Zuoming;Zhang Ruihong;Cheng Yanhui(Department of Orthopedics,the Second Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]唐山市第二医院骨科,063000 [2]唐山市第二医院急诊科,063000

出　　处：《北京医学》2023年第7期593-598,共6页Beijing Medical Journal

基　　金：河北省卫生计生委医学科学研究重点课题计划(20181297、20211416);河北省科技计划(15277790D)。

摘　　要：目的探讨下肢骨折牵引复位装置辅助复位钢板内固定治疗SchatzkerⅥ型胫骨平台骨折的临床康复疗效。方法选取2016年1月至2022年8月唐山市第二医院SchatzkerⅥ型胫骨平台骨折患者600例,根据手术方法分为观察组(413例)和对照组(187例),观察组采用下肢骨折牵引复位装置辅助复位钢板内固定治疗,对照组采用传统切开复位钢板内固定治疗。比较两组围术期指标,术后6个月和术后12个月的美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)、下肢Fugl-Meyer运动功能评价量表(Fugl-Meyer assessment scale,FMA)评分、骨折愈合优良率及术后并发症发生率。结果600例患者中,男383例,女217例,年龄21~65岁,平均(49.5±8.1)岁。观察组手术时间、术中出血量、骨折复位时间和住院时间均低于对照组[(77.93±25.60)min比(103.35±30.75)min、(29.68±10.70)ml比(161.91±23.65)ml、(39.90±20.65)min比(53.30±16.71)min、(7.25±1.70)d比(12.50±2.85)d],术后6个月HSS评分及FMA评分均高于对照组[(85.64±3.31)分比(84.76±3.57)分、(26.53±2.34)分比(25.81±2.41)分],骨折愈合优良率高于对照组(84.50%比59.36%),创伤性关节炎、下肢深静脉血栓、愈合畸形、关节僵硬及切口感染发生率均低于对照组(4.84%比10.16%、0.48%比9.09%、4.84%比12.30%、7.51%比14.44%、1.21%比3.74%),差异均有统计学意义(P<0.05);两组术后12个月HSS评分及FMA评分、钢板周围深层感染发生率的比较,差异无统计学意义(P>0.05)。结论与传统切开复位钢板内固定治疗相比,下肢骨折牵引复位装置辅助复位钢板内固定治疗SchatzkerⅥ型胫骨平台骨折创伤小、术中出血量少、愈合优良率高、并发症少,更有助于膝关节功能及下肢运动功能恢复。Objective To explore the clinical rehabilitation effect of traction reduction device for lower limb fracture assisted by reduction plate internal fixation with steel plate in the treatment of Schatzker type VI tibial plateau fracture.Methods A total of 600 patients with Schatzker type VI tibial plateau fractures treated in Tangshan Second Hospital from January 2016 to August 2022 were selected,and were divided into observation group(413 cases)and control group(187 cases)according to the surgical methods.The observation group were treated with traction reduction device assisted reduction plate internal fixation,while the control group were treated with traditional open reduction and internal fixation with steel plate.The perioperative indicators,hospital for special surgery knee score(HSS),Fugl-Meyer assessment(FMA)score of lower extremity motor function,excellent and good rate of fracture healing and postoperative complication rate at six and 12 months after surgery were compared between the two groups.Results Among the 600 patients,383 were males and 217 were females,aged from 21 to 65 years,with an average age of(49.5±8.1)years.The operative time,intraoperative blood loss,fracture reduction time and hospital stay in the observation group were lower than those in the control group[(77.93±25.60)min vs.(103.35±30.75)min,(29.68±10.70)ml vs.(161.91±23.65)ml,(39.90±20.65)min vs.(53.30±16.71)min,(7.25±1.70)d vs.(12.50±2.85)d].HSS score and FMA score of six months after operation were higher than those of control group[(85.64±3.31)points vs.(84.76±3.57)points,(26.53±2.34)points vs.(25.81±2.41)points],and the excellent and good rate of fracture healing was higher than that of control group(84.50%vs.59.36%),the incidence of traumatic arthritis,lower extremity deep vein thrombosis,healing deformity,joint stiffness and incision infection was lower than those of control group(4.84%vs.10.16%,0.48%vs.9.09%,4.84%vs.12.30%,7.51%vs.14.44%,1.21%vs.3.74%),and the differences were statistically significant(P<0.05).Ther

关 键 词：下肢骨折牵引复位装置 SchatzkerⅥ型 胫骨平台骨折 钢板内固定 膝关节 运动功能 

分 类 号：R687.3[医药卫生—骨科学]