不同切口复位固定治疗复杂胫骨平台骨折  

Analysis of the clinical efficacy of different incision reduction and fixation in the treatment of complex tibial plateau fractures

作　　者：吕飞飞[1] 龚立[1] 成金磊[1] LV Feifei;GONG Li;CHENG Jinlei(Department of Emergency Trauma Orthopedics,Binhu Campus,South District,Hefei First People's Hospital,Hefei 230092,China)

机构地区：[1]合肥市第一人民医院南区滨湖院区急诊创伤骨科,合肥230092

出　　处：《长春中医药大学学报》2024年第8期911-914,共4页Journal of Changchun University of Chinese Medicine

基　　金：安徽省重点研究和开发计划项目(201904a07020097)。

摘　　要：目的探究不同切口复位固定治疗复杂胫骨平台骨折的临床疗效。方法选择复杂胫骨平台骨折患者100例,采用随机数表法分为观察组与对照组,各50例。对照组给予内外侧切口双钢板固定治疗,观察组给予后内侧倒“L”切口辅助外侧切口复位固定治疗。比较2组临床疗效、手术指标、膝关节功能评分(Rasmussen胫骨骨折膝关节功能评分)、疼痛程度评分(VAS)及手术并发症发生情况。结果治疗后,观察组术后3个月后总有效率(70.00%,35/50)显著高于对照组(38.00%,19/50)(P<0.05);2组手术时长、住院时间比较,差异无统计学意义(P>0.05);观察组术后3个月、6个月后Rasmussen胫骨骨折膝关节功能评分高于对照组(P<0.05);观察组术后3个月、6个月后VAS评分均明显低于对照组(P<0.05);观察组术后手术并发症发生率略高于对照组,差异无统计学意义(P>0.05)。结论后内侧倒“L”切口辅助外侧切口复位固复杂胫骨平台骨折更充分、牢固,能够早期行膝关节的功能锻炼,恢复膝关节功能,提高患者生活质量。Objective To explore the clinical efficacy of different incision reduction and fixation in the treatment of complex tibial plateau fractures.Methods A total of 100 patients with complex tibial plateau fractures were selected and divided into the observation group and the control group according to random number table method,with 50 cases in each group.The control group was treated with double-plate fixation through medial and lateral incisions,while the observation group was treated with posterior medial inverted"L"incision assisted by lateral incision for reduction and fixation.Clinical efficacy,surgical index,knee function score(Rasmussen Tibial Plateau Fracture Knee Function Score),pain degree score(Visual Analogue Scale,VAS),and the occurrence of surgical complications were compared between two groups.Results After the treatment,the total effective rate of the observation group(70.00%,35/50)was signicantly higher than that of the control group(38.00%,19/50)at 3 months after surgery(P<0.05).There were no statistically signifi cant diff erences in the duration of surgery and hospital stay between two groups(P>0.05).Rasmussen Tibial Plateau Fracture Knee Function Scores in the observation group were higher than those in the control group at 3 and 6 months after surgery(P<0.05).The VAS scores of the observation group were significantly lower than those of the control group at 3 and 6 months after surgery(P<0.05).The incidence of postoperative surgical complications in the observation group was slightly higher than that in the control group,and there was no statistically significant difference(P>0.05).Conclusion The posterior medial inverted"L"incision assisted by the lateral incision is more suffi cient and fi rm in the reduction and fixation of complex tibial plateau fractures.This therapy can enable early functional exercise of the knee joint,restore the function of knee joint,and improve the quality of life of the patients.

关 键 词：复杂胫骨平台骨折 手术切口 内固定 

分 类 号：R683[医药卫生—骨科学]