胫骨平台双髁骨折合并骨关节炎的临床治疗分析

摘要

目的：探究内固定术结合正清风痛宁注射液治疗胫骨平台双踝骨折合并骨关节炎的疗效,术后并发症发生情况以及骨关节炎改善情况。方法随机选取2014年3月―2015年12月该院接受治疗的胫骨平台双踝骨折合并关节炎的患者70例,所有患者在手术前均接受全面的评估,对合并性疾病要做出积极有效的处理,根据患者的骨折类型以及软组织而的损伤程度确定最佳的手术时机,所有患者均接受内固定和正清风痛宁注射液联合治疗。接受手术后3 dX线片确定手术复位和钢板固定情况；术后6周、4个月、6个月进行随访复查,X线片确定骨折愈合情况,膝关节恢复情况,并进行功能锻炼方面的指导。同时也进行骨性愈合评定。对患者接受治疗前后膝关节疼痛、活动障碍以及肢体周径改善情况进行分析,此外,对患者免疫球蛋白(ICP)和静脉血流速度进行测定结果术后骨折愈合、膝关节恢良好。结果治疗前患者骨关节疼痛、骨关节障碍以及骨关节压痛患者几乎均达到100.0%,但是接受治疗后患者明显少于治疗前,分别为31.43%、48.57%和45.71%且均有所减轻(P<0.05﹚；ICP治疗后为(12.64±1.65﹚mg/mL,明显低于治疗前的值(P<0.05﹚。结论内固定术结合正清风痛宁注射液对胫骨平台双踝骨折合并骨关节炎患者治疗效果明显,并发症较少。%Objective To explore the curative effect of internal fixation combined with the treatment of the tibial plateau fracture with osteoarthritis, the incidence of postoperative complications and the improvement of osteoarthritis.Methods Study selected 2014 March to December 2015 to our hospital accepted treatment of tibial plateau double ankle fracture in 70 cases of patients with arthritis, all patients prior to surgery underwent comprehensive assessment, to make the positive and effective treatment with disease, according to the extent of damage to the patients with the type of fracture and soft tis-sue and to determine the optimal timing of surgery, all patients were treated with fixed and Zhengqing Fengtong Ning Injec-tion combination therapy. Underwent surgery after 3 days of X-ray to determine surgical reduction and plate fixation; post-operative 6 weeks, 4 months, 6 months follow-up, X-ray to determine fracture healing and recovery of knee joint and func-tional exercise guidance. At the same time, bone healing was evaluated. Analysis of knee pain, movement disorder and limb circumference of the patients before and after treatment were analyzed, and the immune globulin (ICP) and venous blood flow velocity were measured. Results Fracture healing and knee joint recovery were good after operation. Before treatment in patients with bone and joint pain, bone and joint disorders and bone and joint pain in patients with almost reached 100%, but after receiving treatment in patients was significantly lower than that of treatment before were 31.43%, 48.57%and 45.71% and were reduced (P< 0.05). After the treatment of ICP for (12.64 ± 1.65) mg / mL was significantly lower than that before treatment values (P< 0.05) Conclusion Internal fixation combined with the treatment of the tibial plateau fracture with the combination of positive and cool breeze and the treatment of the patients with osteoarthritis is obvious, and the complications are less.