解剖钢板内固定联合中药治疗胫骨平台骨折的疗效及对HSS评分的影响

Anatomical Plate Combined with Traditional Chinese Medicine in Treatment of Tibial Plateau Fracture and Impact on HSS Score

目的探讨解剖钢板内固定联合中药治疗胫骨平台骨折的疗效,以及对HSS评分的影响。方法 100例胫骨平台骨折患者均为我院2007年1月～2010年1月骨科住院患者,根据治疗方法不同随机分为观察组(解剖钢板内固定联合中药治疗)与对照组(解剖钢板内固定)各50例,观察比较两组的疗效及手术效果,以及对HSS评分的影响。结果对两组患者的疼痛、功能、关节活动度、肌力、屈曲畸形、关节稳定性,及是否需要支具和内外翻畸形等方面进行HSS评分,结果显示,观察组的有效率为90.0%(45/50),对照组有效率为72.0%(36/50),两组有效率比较差异有统计学意义(P<0.05)。观察组的手术时间、术中术后出血量、骨痂出现时间、骨折愈合时间、住院时间明显分别低于对照组,差异有统计学意义(P<0.05)。而术后HSS评分观察组明显高于对照组,差异有统计学意义(P<0.05)。结论解剖钢板内固定联合中药治疗胫骨平台骨折疗效好,可以明显缩短手术时间,减少术中及术后出血量,提高HSS评分,改善患者的关节功能,值得临床广泛推广和应用。

Objective To investigate the anatomical plate internal fixation combined with traditional Chinese medicine in the treatment of tibial plateau fracture, as well as the impact on the HSS score. Methods A hundred orthopedic inpatients with tibial plateau fracture in our hospital from Jan. 2007 to Jan.2010, according to the different treatment methods,were randomly divided into two groups （observation group, anatomical plate internal fixation combined with Chinese medicine）, with 50 in it and the control group （anatomical plate internal fixation） with 50 in it,and the results of operations,the treatment effect and the impact on the HSS score were observed and compared. Results The HSS scores were carried out in pain,function,joint mobility, muscle strength, flexion deformity,joint stability,and the need for braces and varus deformity , and the results showed that the effective rate of the observation group was 90.0%（45/50）,and that of the control group was 72.0%（36/50）, with a significant difference in the efficiency of the two groups （P〈0.05）.The operation time, intraoperative and postoperative blood loss, bone callus appearance time, fracture healing time and hospitalization time in the observation group were significantly less than those of the control group, with a significant difference（P〈0.05）.The postoperative HSS score of the observation group was significantly higher than that of the control group, with a significant difference （P〈0.05）. Conclusion The anatomical plate internal fixation combined with Chinese medicine shows a good effect on tibial plateau fracture and can reduce operation time , intra-operation and post-operative bleeding and increase HSS score and improve patient joint function, worthy of clinical use and popularization.