基于四柱九区法指导治疗胫骨平台粉碎性骨折67例  

Clinical Efficacy and Reliability of Treatment of Comminuted Tibial Plateau Fracture Based on Four-Column and Nine-Zone Method:67 Cases of Clinical Report

作　　者：仓挺松 陈阳 吴骏 任鹏鹏 曹峰 CANG Tingsong;CHEN Yang;WU Jun;REN Pengpeng;CAO Feng(Suzhou Integrated Traditional Chinese and Western Medicine Hospital,Suzhou 215101,Jiangsu China)

机构地区：[1]苏州市中西医结合医院,江苏苏州215101

出　　处：《中国中医骨伤科杂志》2024年第11期76-81,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:研究经四柱九区法指导治疗胫骨平台粉碎性骨折的临床疗效,探讨应用四柱九区法指导临床治疗的可靠性。方法:回顾性分析2020年12月至2022年1月采用四柱九区法指导治疗的67例胫骨平台粉碎性骨折患者资料,记录并评估患者手术时间、术中出血量、术后的骨折愈合时间与并发症情况,以及术后1,3,6,12个月的胫骨平台后倾角(PTSA)和膝关节功能评分(KSS)。结果:患者平均手术时间为(159.35±18.54)min,平均术中出血量为(116.30±6.64)mL,术后骨折愈合平均时间为(121.42±5.71)d。术后胫骨平台后倾角较稳定,各观察时间点胫骨平台后倾角差异无统计学意义(P>0.05)。术后1个月时膝关节功能评分均显著低于其他观察时间点评分,差异有统计学意义(P<0.05);术后3个月时各评分低于术后6个月和12个月的评分,差异有统计学意义(P<0.05);但术后6个月与12个月之间各评分差异无统计学意义(P>0.05)。共发生并发症11例,其中膝关节僵硬9例,膝外翻1例,膝内翻1例。结论:四柱九区法可较好地指导治疗粉碎性胫骨平台骨折,值得临床推广应用。Objective:To study the clinical effect of four-column and nine-zone method in the treatment of comminuted fracture of tibial plateau,and to explore the reliability of the four-column and nine-zone method in clinical treatment.Methods:From December 2020 to January 2022,67 patients with comminuted fracture of tibial plateau treated with four-column and nine-zone method were selected for a retrospective study without control.Operative time,intraoperative blood loss,postoperative fracture healing time and complications,as well as posterior slope angle and knee function score(KSS)at 1,3,6,12 months after surgery were observed.Results:The mean operative time was(159.35±18.54)min,the mean intraoperative blood loss was(116.30±6.64)mL,and the mean postoperative healing time was(121.42±5.71)d.The posterior slope angle was stable after operation,and there was no statistical difference in the results of posterior slope angle at each observation time point(P>0.05).The scores at 1 month after surgery were significantly worse than those at other observation time points(P<0.05),and the scores at 3 months after surgery were significantly worse than those at 6 months and 12 months after surgery(P<0.05),but there was no statistical difference between 6 months and 12 months after surgery(P>0.05).Complications occurred in 11 cases,including knee stiffness in 9 cases,valgus in 1 case and varus in 1 case.Conclusion:The four-column and nine-zone method can guide the treatment of comminuted tibial plateau fracture,and is worthy of clinical application.

关 键 词：四柱九区法 胫骨平台 粉碎性骨折 回顾性研究 

分 类 号：R683.42[医药卫生—骨科学]