延期手术与早期手术治疗严重胫骨平台骨折的比较研究

COMPARISON OF THERAPEUTIC EFFECTS OF TIBIAL PLATEAU FRACTURE TREATED WITH DEFERRED OPERATION AND EARLY OPERATION

[目的]比较研究延期手术（伤后3-4周）与早期手术（伤后1周内）治疗严重胫骨平台骨折，评估延期手术治疗严重胫骨平台骨折的临床疗效。[方法]回顾性分析比较延期手术治疗胫骨平台骨折48例与早期手术治疗57例的治疗效果。[结果]105例经12-36个月随访，延期手术治疗组：骨折平均愈合时间4个月，48例骨折全部愈合，伤口甲级愈合率89.5%，参照HSS膝关节评分标准[1]：优29例，良13例，可4例，差2例，优良率87.5%，早期手术治疗组：骨折平均愈合时间4个月，骨折全部愈合，伤口甲级愈合率68.4%，优20例，良18例，可11例，差8例，优良率66．6％。对两组疗效进行比较作χ^2检验（P〈0．05）。两组优良率差异有统计学意义。[结论]对严重胫骨平台骨折在伤后3周手术比伤后1周内手术，治疗临床疗效更满意。

[Objective] To evaluate the clinical eltects ot deterred operation （three weeks after tracture） m treatment of tibial plateau fracture in comparison with early operation （one week after fracture）. [Methods] A retrospective analysis was the clinical therapeutic effects of 48 cases of tibial plateau fracture with deferred operation and 57 eases 0peration. [Results]105 case were followed up for 12-36 months. In deferred operation group, the mean healing 4 months 48 cases fracture were all healed, and the rate Of wound healing by first intention was 89.5%; acconling to the effect standard of HSS of knee： 29 cases were excellent, 13 cases were good, 2 cases were acceptable, the rate of excellent and good was 87.5%. In arly operation group, the mean healing time was 4 months, 57 cases fractures were all healed, the rate of wound healing by first intention was 68.4% ; according to the effect standard of HSS of knee ： 20 cases were excellent, 18 cases were good, 8cases were acceptable, the rate of excellent and good was 66.6%. Based on the Chi square test, the rates of excellent and good n two groups were significant different （P 〈 0.05）. [Conclusions] The therapeutic effects of tibial plateau fracture treated with operation three weeks after fracture is more satisfactory than that of operation treatment one week after fracture.