锁定钢板与普通解剖钢板治疗复杂性胫骨平台骨折的临床疗效观察

摘要

目的：观察锁定钢板与普通解剖钢板治疗复杂性胫骨平台骨折的临床疗效。方法回顾性总结分析我院2013年1月~2014年1月期间收治的80例复杂性胫骨平台骨折患者的临床资料,根据内固定方法不同分为观察组(n=40,行锁定钢板内固定)和对照组(n=40,行普通解剖钢板治疗),通过对两组病例的回顾性分析、电话随访、上门随访及复查记录等,比较观察组和对照组的手术时间、术中失血量、完全负重时间、HSS评分、并发症情况,及通过X线及临床检查判断骨折愈合时间。结果观察组平均手术时间(112.3±16.1)min,术中失血量(285.9±21.8)mL,对照组平均手术时间(130.8±22.3)min,术中失血量平均(321.6±37.9)mL。所有患者骨折均获骨性愈合,观察组骨折愈合时间(13.0±1.2)周,完全负重时间(14.1±1.7)周,对照组骨折愈合时间(15.4±2.7)周,完全负重时间(16.5±2.9)周；观察组患者术后HSS评分为(88.3±7.2)分,对照组HSS评分(83.1±6.3)分。两组患者上述的各项指标比较,差异具有统计学意义(P<0.05或P<0.01)；观察组术后1年的优良率达90.0%,显著高于对照组的80.0%,两组患者膝关节功能的优良率比较,差异有统计学意义(P<0.05)；观察组并发症发生率为7.5%,对照组并发症发生率达22.5%,差异具有统计学意义(P<0.05)。结论与普通解剖钢板比较,锁定钢板治疗复杂性胫骨平台骨折具有出血少、骨折愈合快、并发症少等优势,且能显著改善患者的膝关节功能,值得广泛推广和应用。%Objective To observe the clinical curative effect of locking plate and anatomical plate for the treatment of complex tibial plateau fractures. Methods Retrospective analyzed clinical data of 80 cases of complex tibial plateau treated in our hospital from January 2013 to January 2014, according to the different internal fixation methods and di-vided into observation group (n=40, locking plate fixation) and control group (n=40, normal anatomical steel plate treatment), through the review and analysis home visits, telephone follow-up, and review records of two groups were compared, the operation time, blood loss, operation group and control group in the amount, full weight bearing time, HSS score, complications, and the healing time of fracture by X-ray and clinical examination judgment were compared. Results The average operation time of observation group was(112.3±16.1)min, intraoperative blood loss(285.9±21.8)mL, the average operation time of control group was(130.8±22.3)min, blood loss(321.6±37.9)mL. All fractures were healed, the healing time of observation group was(13.0±1.2) weeks, full weight bearing time (14.1±1.7) weeks, the control group of fracture healing time (15.4±2.7)weeks, full weight bearing time was(16.5±2.9) weeks; HSS score of the ob-servation group was (88.3±7.2)points, the control group was (83.1±6.3)points. Comparison of two groups of patients with the above indexes, with significant difference (P<0.05 or P<0.01), the excellent rate 1 year after the operation of observation group was 90.0%, significantly higher than that in control group, the excellent and good rate was 80.0%, excellent rate of two groups with knee joint function, the difference was significant (P<0.05); the complication rate of observation group was 7.5%, the control group was 22.5%, with significant difference (P<0.05). Conclusion Compared with normal anatomical plate, the complex tibial plateau fracture locking has less bleeding, fast fracture healing, less complications and other advantages of steel plate, and can significantly improve the knee joint function of patients, is worthy of popularization and application.