锁定钢板内固定治疗复杂胫骨平台骨折临床分析

摘要

Objective Through the clinical treatment experience and the correlation analysis, is ex-tremely superior to analysis the clinical value of locking plate fixation in the treatment of complex tibial plat-eau fractures. Methods Selection of baoding city evergreen combine traditional Chinese and western medi-cine hospital between December 2009 and December 2009,35 patients with complex tibial plateau fractures treated,randomly divided into two groups,a group of 19 locking plate internal fixation treatment,routine for locking plate internal fixation group,a group of 16 patients with locking plate internal fixation treatment with joints restorer( CPM) training, record for locking plate internal fixation plus CPM group, observe the two groups of patients after surgery and treatment effect. Results Two groups of patients were follow-up, after an average follow-up time of 20. 6 months. Locking plate internal fixation plus CPM group in the knee joint func-tion after surgery was 81. 25%, significantly higher than the value of locking plate fixation for 63. 16%(P<0. 05),statistically significant;Locking angle is fixed CPM group of posterior tibial plate wad (5. 6 ± 0. 8) °, locking plate fixation group was (4.7 ±0.9) °, there was significant difference between two groups(P<0. 05). Conclusion Method of locking plate fixation for the treatment of complex tibial plateau fracture ca-ses has the advantages of good effect of operation,rapid postoperative recovery and less complications,can im-prove the patient's knee joint function,in the complex tibial plateau current cases of fracture is a kind of non ideal operation scheme. Combined with CPM rehabilitation training,it will be a very ideal treatment,and be worthy of our hospital and physician colleagues to promote the use of in therapy.%目的：分析锁定钢板内固定治疗复杂胫骨平台骨折的临床价值及优越性。方法选取2009年12月至2012年12月保定市恒兴中西医结合医院收治的复杂胫骨平台骨折患者35例，依据随机数字表法分为两组：锁定钢板内固定组(19例)行锁定钢板内固定治疗；锁定钢板内固定+CPM组(16例)采用锁定钢板内固定治疗并伴有关节恢复器(CPM)训练。观察两组患者的手术情况及治疗后的效果。结果术后两组患者均获得随访，平均随访时间20.6个月。锁定钢板内固定+CPM组在进行手术后膝关节功能优良率显著高于锁定钢板内固定组(81.25% vs 63.16%)(P<0.05)；锁定钢板内固定+CPM组胫骨平台后倾角为(5.6±0.8)°，锁定钢板内固定组为(4.7±0.9)°，两组比较差异有统计学意义(P<0.05)。结论用锁定钢板内固定的方法治疗复杂胫骨平台骨折具有手术效果好、术后恢复快以及并发症较少等优点，可以改善患者的膝关节功能，再结合CPM康复训练，是一种非常理想的治疗方案，值得临床推广运用。