双切口双钢板内固定治疗老年胫骨平台骨折的临床疗效  

Clinical efficacy of double incision and double plate internal fixation in the treatment of tibial plateau fractures in the elderly

作　　者：缪小兵 洪克建 戴永平 张君 MIAO Xiaobing;HONG Kejian;DAI Yongping;ZHANG Jun(Department of Orthopaedics,Rugao Hospital affiliated to Nantong University(Rugao People’s Hospital),Nantong,Jiangsu 226500,China)

机构地区：[1]江苏省南通大学附属如皋医院(如皋市人民医院)骨科,226500

出　　处：《临床外科杂志》2024年第8期874-877,共4页Journal of Clinical Surgery

摘　　要：目的探讨双切口双钢板内固定治疗老年胫骨平台骨折的临床效果及对膝关节功能的影响。方法2015年4月~2021年5月收治的老年胫骨平台骨折病人103例,按手术方法分为两组,研究组52例,采用双切口双钢板治疗;对照组51例,采取锁定钢板内固定治疗。比较两组的围手术期指标、膝关节功能、膝关节稳定性、膝关节并发症。结果研究组住院时间为(7.8±2.0)天,对照组为(10.0±2.4)天,两组比较,差异有统计学意义(P<0.05);研究组术后3个月、6个月、12个月的HSS评分分别为(66.9±5.4)分、(78.4±6.6)分和(83.8±6.1)分,对照组分别为(64.2±6.1)分、(74.0±7.3)分和(82.0±6.8)分,两组术后3个月、6个月的HSS评分比较,差异有统计学意义(P<0.05);术后3个月研究组的胫骨迁移距离为(2.54±0.50)mm,对照组为(2.84±0.67)mm,两组比较,差异有统计学意义(P<0.05);研究组术后3个月、6个月、12个月膝关节后倾角分别为(4.12±1.10)°、(5.03±0.96)°和(5.46±1.52)°,对照组分别为(6.11±1.43)°、(6.67±1.54)°和(7.50±1.88)°,两组比较,差异有统计学意义(P<0.05);研究组术后3个月、6个月的活动度分别为(104.3±8.2)°和(117.4±7.6)°,对照组分别为(96.8±8.9)°和(111.8±8.2)°,两组比较,差异有统计学意义(P<0.05);研究组术后出现并发症3例,对照组10例,两组比较,差异有统计学意义(P<0.05)。结论双切口双钢板内固定治疗老年胫骨平台骨折临床效果肯定,对于促进术后早期膝关节功能恢复、维持膝关节功能稳定较锁定钢板内固定更加有利。Objective To investigate the clinical effect of dual incision and dual plate internal fixation for the treatment of tibial plateau fractures in the elderly and its impact on knee joint function.Methods Using retrospective analysis method,103 elderly patients with tibial plateau fractures admitted to Rugao Hospital affiliated to Nantong University from April 2015 to May 2021 were selected for clinical research.According to the surgical method,they were divided into two groups,52 patients in the study group were treated with double incision double plates,and 51 patients in the control group were treated with locking plate internal fixation.Perioperative indicators,knee function,knee stability Knee joint complications.Results The hospitalization time of the study group was(7.8±2.0)days,and that of the control group was(10.0±2.4)days,and the difference was statistically significant between the two groups(P<0.05).The HSS scores at 3 months,6 months and 12 months were(66.9±5.4),(78.4±6.6)and(83.8±6.1)in the study group,and(64.2±6.1),(74.0±7.3)and(82.0±6.8)in the control group,respectively.There was statistical significance in HSS scores 3 months and 6 months after operation between the two groups(P<0.05).The tibial migration distance 3 months after operation was(2.54±0.50)mm in the study group and(2.84±0.67)mm in the control group,and the difference was statistically significant(P<0.05).The knee posterior inclination angles of the study group were(4.12±1.10)°,(5.03±0.96)°and(5.46±1.52)°at 3 months,6 months and 12 months after surgery,respectively,while those of the control group were(6.11±1.43)°,(6.67±1.54)°and(7.50±1.88)°,respectively.The difference was statistically significant(P<0.05).The activity of the study group at 3 months and 6 months after surgery was(104.3±8.2)°and(117.4±7.6)°,respectively,while that of the control group was(96.8±8.9)°and(111.8±8.2)°,and the difference was statistically significant(P<0.05).There were 3 cases of postoperative complications in the study group and

关 键 词：双切口 双钢板 内固定 老年 胫骨平台骨折 

分 类 号：R687.3[医药卫生—骨科学]