摘要
目的探讨研制的反向牵引装置在高能量胫骨平台骨折术前的应用效果。方法回顾分析2020年12月—2023年12月收治且符合选择标准的33例高能量胫骨平台骨折患者临床资料。患者均采用切开复位钢板内固定治疗,根据术前牵引方法分为观察组(16例,入院当天使用反向牵引装置进行治疗),对照组(17例,入院当天行跟骨牵引治疗)。两组患者性别、年龄、身体质量指数、患侧侧别、致伤原因、骨折Schatzker分型等基线资料比较差异均无统计学意义(P>0.05)。记录并比较两组患者术前等待时间、术前相关并发症(钉道松动、钉道渗液、钉道感染、软组织坏死、软组织感染、下肢深静脉血栓形成等)、手术时间、总住院时间。牵引后第4天采用疼痛视觉模拟评分(VAS)评价患者疼痛缓解情况,测量患侧肢体肿胀值,采用制动舒适度评分表(ICQ)评估患者围术期住院舒适度。结果两组患者均顺利完成手术,观察组手术时间、总住院时间及术前等待时间均少于对照组,差异有统计学意义(P<0.05)。观察组无术前相关并发症;对照组3例患者出现钉道松动并渗液,2例发生下肢深静脉血栓形成;两组并发症发生率比较差异有统计学意义(P<0.05)。牵引后第4天观察组ICQ评分、VAS评分及患侧肢体肿胀值均优于对照组,差异有统计学意义(P<0.05)。X线片示对照组跟骨牵引后胫骨平台骨折分离及下肢力线有所恢复,但不如观察组恢复明显;观察组骨折间隙明显减小,胫骨平台对位对线良好,侧方成角畸形纠正。结论高能量胫骨平台骨折患者入院后采用反向牵引装置治疗可加快软组织周围肿胀消退、减轻患者疼痛、缩短术前等待时间,提高患者术前生活质量,有利于缩短手术时间,疗效良好。
Objective To investigate the effectiveness of the reverse traction device in the preoperative treatment of high-energy tibial plateau fractures.Methods A retrospective study was conducted to analyze the clinical data of 33 patients with high-energy tibial plateau fractures who met the selection criteria between December 2020 and December 2023.All patients were treated by open reduction and internal fixation.According to the preoperative traction method,they were divided into the observation group(16 cases,treated with a reverse traction device on the day of admission)and the control group(17 cases,treated with heel traction on the day of admission).There was no significant difference in baseline data such as gender,age,body mass index,affected side,cause of injury,fracture Schatzker classification between the two groups(P>0.05).Preoperative waiting time,preoperative related complications(nail channel loosening,nail channel oozing,nail channel infection,soft tissue necrosis,soft tissue infection,deep vein thrombosis of the lower extremity,etc.),operation time,and total hospitalization time were recorded and compared between the two groups.On the 4th day after traction,visual analogue scale(VAS)score was used to evaluate the pain relief of the patients,the swelling value of the affected limb was measured,and the Immobilization Comfort Questionnaire(ICQ)score was used to evaluate the perioperative hospital comfort of the patients.Results Both groups of patients completed the operation successfully,and the operation time,total hospitalization time,and preoperative waiting time of the observation group were significantly less than those of the control group(P<0.05).There was no preoperative related complications in the observation group;in the control group,3 patients had nail channel loosening and oozing,and 2 cases had the deep vein thrombosis of the lower extremity;the difference in the incidence of complication between the two groups was significant(P<0.05).On the 4th day after traction,the ICQ score,VAS score,and
作者
陈明礼
陈宗霖
李洪瀚
陈进鸿
高鸿鹏
黄淼
薛观錡
林泽鹏
杨荣源
CHEN Mingli;CHEN Zonglin;LI Honghan;CHEN Jinhong;GAO Hongpeng;HUANG Miao;XUE Guanqi;LIN Zepeng;YANG Rongyuan(Department of Orthopedics,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou Fujian,363000,P.R.China;School of Clinical Medicine,Fujian Medical University,Fuzhou Fujian,350004,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2024年第7期830-835,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
漳州市医院博士工作室攀登课题(PDB202207)。
关键词
胫骨平台骨折
反向牵引
跟骨牵引
舒适度
Tibial plateau fracture
reverse traction
calcaneal traction
comfortable level
