苏氏正骨法与外固定结合治疗胫骨平台骨折

Treatment of tibial plateau fracture with Sushi method of manipulation combined with external fixation

目的：比较苏氏正骨法结合外固定与内固定治疗胫骨平台的疗效。方法：本组240例胫骨平台骨折中男185例,女55例;年龄24~64岁,平均42岁。随机分为外固定组（A组）和内固定组（B组）,每组120例,分别采用苏氏整复手法结合外固定器（A组）和切开复位钢板螺钉内固定（B组）治疗,比较两种疗法的疗效。结果：240例均获随访,随访时间6~20个月,平均12.4个月,按临床功能评分标准：A组优25例,良88例,可6例,差1例,优良率94.17%;B组优11例,良86例,可23例,差0例,优良率80.83%。两组疗效经秩和检验,差异有显著性意义（P〈0.01）。结论：苏氏正骨法与外固定结合是治疗胫骨平台骨折的一种有效方法,但越膝外固定器限制膝关节活动,需进一步改进成带活动轴可屈曲式外固定器。

Objective： To compare therapeutic effects of Sushi method of manipulatior combined with external fixation and internal fixation for treating tibial plateau fracture. Methods： Two hundreds and forty patients with tibial plateau fractures were divided into external fixation group （ Group A ） and internal fixation group （ Group B ） randomly, and each group included 120 patients. Among the patients, 185 patients were male and 55 patients were female, ranging in age from 24 to 64 years, with an average of 42 years. The patients in Group A were treated with Sushi method of manipulation combined with external fixation, and patients in Group B were treated with open redution and internal fixation with plate and screw. Results ： All the patients were followed-up for 6 to 20 months （ mean 12. 4 months）. According to the HHS knee scores,in Group A,25 patients obtaned an excellent result,88 good,6 poor and 1 bad,the excellent and good rate was 94. 17% ;while in Group B,the above results were 11,86,23,0 and 80. 83% respectively. There was significant difference of therapeutic effects between two groups （P 〈 0.01 ）. Conclusion： The method of Sushi manipulation combined with external fixation is an effective methocl to treat tibial plateau fracture. But the external fixator cross knee joint limits its movement, and the external fixator should be improved to flexible fixator with action axis.