双切口双钢板内固定术对胫骨平台骨折患者愈合程度、稳定性、骨代谢的影响  

Effect of double-incision double-plate internal fixation on the degree of healing,stability and bone metabolism of patients with tibial plateau fracture

作　　者：吴应国 邵建敏 徐军志 温恒萍 刘华凯 蒋星海 WU Ying-guo;SHAO Jian-min;XU Jun-zhi(Jingdezhen Third People's Hospital,Jingdezhen 333000,China)

机构地区：[1]景德镇市第三人民医院,333000

出　　处：《中国现代药物应用》2024年第17期53-56,共4页Chinese Journal of Modern Drug Application

基　　金：景德镇科技计划项目(项目编号:20212SFZC015)。

摘　　要：目的 观察双切口双钢板内固定术对胫骨平台骨折患者愈合程度、稳定性、骨代谢的影响。方法 68例胫骨平台骨折患者作为观察对象,根据手术治疗方案的不同将患者分为对照组(单侧钢板内固定术治疗)和试验组(双切口双钢板内固定术治疗),各34例。比较两组患者手术相关指标及愈合情况、临床疗效、手术相关并发症发生情况、骨折复位后的稳定性[术后即刻及3、6个月的胫骨平台内翻角及后倾角]、术后血清骨代谢指标[骨钙素(BGP)、人降钙素(hCT)及骨特异性碱性磷酸酶(BALP)]。结果 两组患者手术操作耗时、术中出血总量及切口长度比较,差异不具有统计学意义(P>0.05);试验组患者术后开始锻炼时间(5.54±1.03)d、下地负重时间(5.03±0.75)周及骨折愈合时间(11.04±1.78)周相比于对照组患者的(9.65±2.48)d、(6.75±1.02)周、(14.89±2.20)周明显更短(P<0.05)。术后3、6个月,试验组患者膝关节功能恢复优良率分别为67.65%、91.18%,均高于对照组的38.24%、70.59%(P<0.05)。试验组患者并发症发生率8.82%低于对照组的29.41%(P<0.05)。术后3、6个月时,试验组患者胫骨平台内翻角与术后即刻比较,差异不具有统计学意义(P>0.05);对照组患者胫骨平台内翻角与术后即刻比较明显变大,且对照组显著大于试验组(P<0.05);两组患者胫骨平台后倾角与术后即刻比较均明显变大,且对照组患者明显大于试验组(P<0.05)。术后3、6个月,试验组患者血清BGP、hCT及BALP水平明显高于对照组(P<0.05)。结论 采用双切口双钢板内固定术治疗胫骨平台骨折的临床效果明显优于单侧钢板内固定术,能够加快患者的骨折愈合速度,预防或减少术后并发症的发生,更具有生物力学上的稳定性,能够促进骨折部位的骨代谢及骨愈合。Objective To observe the effect of double-incision double-plate internal fixation on the degree of healing,stability and bone metabolism of patients with tibial plateau fracture.Methods 68 patients with tibial plateau fracture were divided into a control group(unilateral plate internal fixation) and an experimental group(double-incision double-plate internal fixation) according to different surgical treatment plans,each with 34 cases.Patients in both groups were compared in terms of surgical indicators and healing status,clinical efficacy,occurrence of surgery-related complications,stability after fracture reduction [varus inclination and caster angle of the tibial plateau immediately after surgery,3 and 6 months after surgery],postoperative serum bone metabolic markers [osteocalcin(BGP),human calcitonin(hCT) and bone-specific alkaline phosphatase(BALP)].Results There was no statistically significant difference in operation time,total amount of intraoperative bleeding and incision length between the two groups(P>0.05).In the experimental group,the postoperative exercise time was(5.54±1.03) d,the weight-bearing time was(5.03±0.75) weeks and the fracture healing time was(11.04±1.78) weeks,which were significantly shorter than(9.65±2.48) d,(6.75±1.02) weeks and(14.89±2.20) weeks in the control group(P<0.05).At 3 and 6 months after surgery,the excellent and good recovery rates of knee function in the experimental group were 67.65% and 91.18%,which were higher than 38.24% and 70.59% in the control group(P<0.05).The complication rate of 8.82% in the experimental group was lower than 29.41% in the control group(P<0.05).At 3 and 6 months after surgery,there was no statistically significant difference in the varus inclination of the tibial plateau in the experimental group compared with immediately after surgery(P>0.05).The varus inclination of the tibial plateau of the control group increased significantly compared with immediately after surgery,and the control group was significantly larger than the experimental g

关 键 词：双切口双钢板内固定术 胫骨平台骨折 愈合程度 稳定性 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]