摘要
目的比较锁定钢板与双切口双钢板内固定治疗复杂性胫骨平台骨折(CTPF)的临床疗效。方法回顾性分析2015年5月至2017年4月榆林市第一医院骨科收治的146例CTPF患者的临床资料,按照治疗方法不同分为A组和B组,每组各73例。A组采用双切口双钢板内固定,B组采用锁定钢板内固定,对比两组患者手术时间、术中出血量、住院时间、完全负重下地时间、骨折愈合时间、膝关节开始功能锻炼时间、术后胫骨平台内翻角(TPA)和内侧后倾角(PA)的度数、术后随访膝关节功能恢复情况及术后并发症发生情况。结果 A组患者术后膝关节开始功能锻炼时间短于B组(5.69±1.08 d vs.15.36±1.22 d,P<0.05),A组患者术后完全负重下地时间及骨折愈合时间均长于B组,组间比较差异具有统计学意义(18.25±1.86周vs.11.36±1.37周,28.21±1.58周vs.18.52±1.33周,P<0.05)。两组患者术后12个月TPA、PA的度数比较,差异无统计学意义(P>0.05)。两组患者膝关节功能评分表(HSS)优良率分别为86.3%(63/73)、87.7%(64/73),组间比较差异无统计学意义(P>0.05)。A组患者术后膝关节僵直率为1.4%(1/73),低于B组的16.4%(12/73)(P<0.05)。结论锁定钢板与双切口双钢板内固定治疗CTPF的临床疗效相似,均可获得较为满意的固定稳定性,且愈后下肢力线好,膝关节功能恢复率较高,但仍各具优缺点,临床需根据实际情况选择合理术式。
Objective To compare the clinical effect of locking plate and double incision double plate internal fixation to treat complicated tibial plateau fracture（ CTPF）. Methods The clinical data of 146 patients with CTPF in Department of orthopedics of Yulin First Hospital from May 2015 to April 2017 were analyzed retrospectively. According to the treatment methods,the patients were divided into group A and group B,with 73 cases in each group. Group A was fixed with double incision and double plate,and group B was fixed with locking plate. The operation time of the two groups,the amount of bleeding,the time of hospitalization,the time of full weight load,the time of fracture healing,the time of the starting function of the knee joint,the Tibial plateau varus angle,TPA,and the inner side of the tibial plateau（ TPA） and the inside of thetibial plateau were compared. The degree of Medial inclination angle（ PA）,postoperative recovery of knee joint function and postoperative complications were observed. Results The time of starting functional exercise of knee joint in group A was shorter than that in group B（ 5. 69 ± 1. 08 d vs. 15. 36 ± 1. 22 d,P〈0. 05）. The time of full weight bearing and fracture healing time in group A were longer than that of B group,and the difference between groups was statistically significant（ 18. 25 ± 1. 86 week vs. 11. 36 ± 1. 37 week,P〈0. 05）. There was no significant difference in the degree of TPA and PA between the two groups at 12 months after operation（ P〉0. 05）. The good rate of knee joint function（ HSS）in the two groups was 86. 3 %（ 63/73） and 87. 7 %（ 64/73） respectively,and there was no significant difference between the groups（ P〉0. 05）. The knee stiffness in group A was 1. 4%（ 1/73）,lower than that in group B（ 12/73）（ 16. 4%）（ P〈0. 05）. Conclusion Using the steel plate and double incision double steel plate internal fixation to treat CTPF clinical curative effect similar to that of a relatively satisfactory stability
作者
白晓兵
任龙龙
路星
BAI Xiao - bing;REN Long - long;LU Xing(Hand and Foot Surgery of Yulin First Hospital,Yulin Shaanxi 719000,China;Yulin Second Hospital,Yulin Shaanxi 719000,China;People＇s Hospital of Huanglong Cbunty,Huanglong Shaanxi 715700,China.)
出处
《临床和实验医学杂志》
2018年第16期1754-1757,共4页
Journal of Clinical and Experimental Medicine
基金
陕西省卫生厅科研基金项目(编号:2015JM4029)
关键词
复杂性胫骨平台骨折
内固定
锁定钢板
双切口双钢板
Complex tibial plateau fracture
Internal fixation
Locking plate
Double cut double plate
