摘要
目的 探讨切开复位钢板内固定治疗胫骨平台骨折（FTP）的临床疗效及对膝关节功能恢复的影响.方法 选取50例胫骨平台骨折患者,均行切开复位钢板内固定治疗.记录手术时间、术中出血量、石膏制动时间、住院时间及骨折愈合时间,并统计并发症发生率;术后3 d行影像学检查评估手术复位效果;术后随访6个月,对比手术前后膝关节功能（HSS）评分,并以HSS评分标准评估临床疗效.结果 50例胫骨平台骨折患者内固定手术均获得成功,手术时间为（101.36±15.63）min,术中出血量为（291.45±34.98）mL,住院时间为（6.85±1.21）d,术后石膏制动时间为（20.35±3.67）d,骨折愈合时间为（87.63±2.36）d;50例患者中未出现复位不满意病例,40例复位优,7例复位良,3例复位为满意;术后发生切口感染2例,肺栓塞1例,骨不连1例及筋膜间室综合征1例,并发症总发生率为10.0%;术后6个月,HSS评分（疼痛、功能、活动范围、肌力、屈曲畸形、关节稳定性）较手术前明显提高,差异均有统计学意义（t=12.070、17.241、19.986、10.850、21.098、10.238,均P=0.000）;50例胫骨平台骨折患者手术效果优23例,良19例,可7例,差1例,优良率为84.0%.结论 切开复位钢板内固定治疗胫骨平台骨折能够取得满意复位效果,且具有一定安全性,可有效促进骨折愈合及患者膝关节功能恢复与改善,临床效果显著.
Objective To evaluate the effect of open reduction and internal fixation in the treatment of 50 patients with tibial plateau fractures（FTP）,and its influence on knee functional recovery.Methods 50 patients with FTP were treated with open reduction and internal fixation.The operation time,blood loss,gypsum braking time,hospitalization time and fracture healing time were recorded,and the incidence of complication was analyzed as well.3 days after operation,imaging evaluation was performed to evaluate the effect of operation reduction.The patients were followed up for 6 months.The HSS scores before and after operation were compared,and the clinical efficacy was evaluated by HSS score.Results 50 FTP patients treatment with internal fixation were successful.The operation time was （101.36±15.63）min,the blood loss was （291.45±34.98）mL,the hospitalization time was （6.85±1.21）d,the postoperative plaster brake time was （20.35±3.67）d,the fracture healing time was （87.63±2.36）d.50 patients were all satisfied to reset,excellent reduction in 40 cases,good reduction in 7 cases,satisfaction in 3 cases,postoperative incision infection in 2 cases,pulmonary embolism in 1 case,nonunion in 1 case and fascia compartment syndrome in 1 case,the total incidence rate of complications was 10.0%.6 months after operation,the HSS scores（pain,function,range of motion,muscle strength,flexion deformity,joint stability） were significantly higher than before operation（t=12.070,17.241,19.986,10.850,21.098,10.238,all P=0.000）.Of 50 cases with FTP,excellent in 23 cases,good in 19 cases,fair in 7 cases and poor in 1 case,the excellent and good rate was 84.0%.Conclusion Open reduction and internal fixation in the treatment of FTP gets satisfactory reduction effect,it has certain safety,and it can effectively promote fracture healing and knee functional recovery and improvement,its clinical effect is remarkable.
作者
罗雄生
Luo Xiongsheng(Department of Orthopedics and Traumatology, the Traditional Chinese Medicine Hospital of Daishan County, Zhejiang 316200, China)
出处
《中国基层医药》
CAS
2017年第12期1888-1891,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
胫骨骨折
骨折固定术
内
骨固定钢丝
手术复位损伤
Tibial fractures
Fracture fixation
internal,Bone wires
Surgical reduction injury
