两种方法治疗较短胫骨远端干骺端骨折的疗效比较

Comparison of two fixed methods for very short distal metaphyseal fracture of tibia

[目的]比较胫骨远端前外侧"L"型锁定钢板与胫骨远端内侧锁定钢板治疗胫骨远端较短干骺端骨折的临床疗效。[方法]对2005年3月～2011年2月期间63例胫骨较短远端干骺端骨折(远断端距关节面的距离<3 cm)进行回顾性分析,其中30例应用"L"型锁定钢板固定,33例应用远端内侧锁定钢板固定。对每例患者的手术时间、骨折愈合时间、并发症发生率及踝关节功能评分等进行统计学分析。[结果]63例获得随访,平均随访15.2个月,平均手术时间、手术出血量、骨折愈合时间(P>0.05),并发症的发生率内侧锁定钢板组高于"L"型锁定钢板组(P<0.05),术后优良率"L"型锁定钢板组高于内侧锁定钢板组(P<0.05)。[结论]胫骨远端"L"型锁定钢板治疗较短胫骨远端干骺端骨折效果好,手术并发症少,是一种较为理想的内固定方式。

[ Objective ] To compare the effects of lateral distal tibia1 L - shape locking plate and medial distal tibial locking plate for the fractures of the distal tibia with very short metaphyseal fragments in clinic. [ Method] Sixty-three patients with very short distal metaphyseal fracture of tibia treated with internal fixation were followed up from March 2005 to February 2011. Thirty patients were treated with lateral distal tibial L-shape locking plate, 33 patients were treated with medial distal tibial locking plate. Operative time, the blood lost, fracture union time, complications and ankle function scores were recorded according to Joh- ner-Wruhs scoring system. [ Result] All patients were followed up for 12 to 24 months （ 15.2 months in average）. There were no significant diferences in operative time, blood loss and union time between two groups （P 〉 0.05 ）. There was significant difference in the excellent result rate and complications rate （P 〈 O. 05 ）. [ Conclusion ] The lateral distal tibial L-shape locking plate is an effective way to treat the fractures of the distal tibia with very short metaphyseal fragments. The lateral distal tibial L-shape locking plate has advantages of less complications and good functional recovery of ankle.