摘要
目的探讨不同植骨方式治疗胫骨平台骨折的效果。方法 2012年3月至2014年6月,在我院接受治疗的45例胫骨平台骨折患者为观察对象。根据其治疗方式分为开窗夯实植骨组(22例)和填塞植骨组(23例)。观察两组患者的疗效,骨折复位和愈合情况、比较两组患者早晚期并发症和膝关节Rasmussen评分的差异。结果填塞植骨组切口愈合时间和骨痂出现时间分别为(18.96±4.18)天和(5.53±1.05)周;开窗夯实植骨组切口愈合时间和骨痂出现时间分别为(19.02±3.39)天和(5.62±1.13)周;两组间比较差异无统计学意义;开窗夯实植骨组患者的手术效果明显优于填塞植骨组,差异有统计学意义(P=0.035);两组患者术后下肢深静脉血栓、切口周围脂肪液化等并发症发生率差异无统计学意义(P=0.673、0.157、0.301、0.323);两组患者术后3个月和6个月时的膝关节Rasmussen评分分别为(15.97±2.13)分和(16.02±3.05)分,(18.36±3.16)分和(18.52±3.23)分,两组间比较差异无统计学意义(P=0.475、0.434),术后9个月时,开窗夯实植骨组的膝关节Rasmussen评分为(26.45±4.01)分,明显高于填塞植骨组(23.62±3.75)分(P=0.009)。结论相比填塞植骨术,开窗夯实植骨术对胫骨平台骨折有较好的治疗效果。患者预后好,并发症发生率低,利于膝关节功能的恢复。
Objective To investigate the results of different bone graft ways in the treatment of tibial plateau fractures. Methods A total of 45 cases of tibial plateau fractures treated in our hospital from March 2012 to June 2014 were selected as objects. According to the treatment methods, they were divided into 2 groups： fenestration tamping bone graft group（ n = 22） and packing bone graft group（ n = 23）. The curative results, fracture reduction and healing of the 2 groups were observed, and early and late complications and Rasmussen scores of the knee joint were compared between the 2 groups. Results Wound healing time and time of callus occurrence were（ 18.96 ± 4.18） days and（ 5.53 ± 1.05） weeks in packing bone graft group, which were（ 19.02 ± 3.39） days and（ 5.62 ± 1.13） weeks in fenestration tamping bone graft group, and there were no obvious differences between the 2 groups. The surgical results of fenestration tamping bone graft group were significantly better than that of packing bone graft group, and the differences were statistically significant（ P = 0.035）. There were no statistically significant differences in the incidence of postoperative complications such as deep venous thrombosis of the lower limb and fat liquefaction around the incision（ P = 0.673, 0.157, 0.301, 0.323） between the 2 groups. Rasmussen scores of the knee joint were（ 15.97 ± 2.13） and（ 16.02 ± 3.05）,（ 18.36 ± 3.16） and（ 18.52 ± 3.23） at 3 and 6 months after the operation in the 2 groups, and there were no statistically significant differences between the 2 groups（ P = 0.475, 0.434）. At 9 months after the operation, Rasmussen score of the knee joint was 26.45 ± 4.01 in fenestration tamping bone graft group, which was significantly higher than（ 23.62 ± 3.75） in packing bone graft group（ P = 0.009）. Conclusions It is better to treat tibial plateau fractures with fenestration tamping bone graft than packing bone graft, with the advantages of excellent curative results, goo
出处
《中国骨与关节杂志》
CAS
2017年第4期292-296,共5页
Chinese Journal of Bone and Joint
关键词
胫骨
骨折
膝关节
植骨
Tibia
Fractures
bone
Knee joint
Bone graft
