锁定加压钢板与解剖钢板治疗胫骨Pilion骨折疗效比较

Comparative study on curative effect of locking compression plate fixation and anatomical plate in treatment of Pilion fractures

[目的]总结比较锁定加压钢板(locking compression plate,LCP)与解剖钢板在胫骨Pilion骨折中的临床疗效。[方法]回顾2002年5月～2010年3月采用锁定加压钢板及解剖钢板治疗的胫骨Pilion骨折47例。LCP组25例,男20例,女5例,年龄19～61岁,平均37岁。按AO分型:A型13例,B型7例,C型5例。解剖钢板组22例,男19例,女3例;年龄23～64岁,平均39岁。按AO分型:A型11例,B型6例,C型5例。比较两组的手术时间、出血量、恢复工作时间、骨折愈合时间、踝关节功能及并发症发生率,参照Mazur标准评价踝关节功能。[结果]两组均随访10个月以上,LCP组随访10个月～4年,平均25.2个月。解剖钢板组随访10个月～5年,平均26.5个月。两组均骨折愈合,LCP组手术时间、手术切口、出血量、恢复工作时间、骨折愈合时间、踝关节功能及并发症发生总数优于解剖钢板组,差异有统计学意义(P<0.05)。[结论]LCP及解剖钢板治疗胫骨远端骨折均可获得满意效果,但LCP具有创伤小、骨折愈合快、并发症少等优点,更加符合生物学固定原则,是治疗Pilion骨折的有效手段。

[Objective] To compare the clinic effect of the locking compression plate（LCP）fixation and the anatomical plate in treatment of Pilion fractures.[Method]The study involved 47 patients with Pilion fractures treated between May 2002 and March 2010.The LCP group included 25 patients（20 males and 5 females,age 19 to 61 years,at average age of 37 years）,of whom there were 13 patients with type A fractures,7 with type B and 5 with type C according to the AO/ASIF classification.The anatomical plate group included 22 patients（19 males and 3 females,age 23 to 64 years,at average age of 39 years）,of whom there were 11 patients with type A fractures,6 with type B and 5 with type C according to the AO/ASIF classification.The operation time,intra-operative blood loss,recovery time,bone healing time,post-operative complications and therapeutic effects were compared between both groups.Mazur＇s criteria was used to evaluate the function of the ankle. [Result]Both groups were followed up for 10 months or more,LCP group was followed up for 10 to 4 years（average,25.2 months） and anatomical plate group was followed-up for 10 to 5-years（average,26.5 months）,which showed fracture healing in all the patients.The operation time,incision size,blood loss,postoperative complications and bone healing time in the LCP group were significantly less than those in the anatomical plate group,the difference was statistically significant（P0.05）.[Conclusion]Both the LCP and anatomical plate are effective methods for Pilion fractures.LCP has advantages of less trauma,quick fracture healing and less complications,is more consistent with the biomechanics of internal fixation and hence is an ideal method for the treatment of Pilion fractures.