双切口微创下LISS钢板治疗复杂胫骨平台骨折疗效分析

Two-incision minimally invasive LISS plate for treatment of complex tibial plateau fractures

目的探讨双切口微创下LISS钢板治疗复杂闭合性胫骨平台骨折(SchatzkerⅤ、Ⅵ型)的临床疗效。方法按入院先后顺序,将37例复杂胫骨平台骨折(SchatzkerⅤ、Ⅵ型)患者随机分为观察组(n=22)和对照组(n=15)。全部采用膝前外侧联合后内侧切口复位并固定骨折。观察组使用LISS钢板固定,对照组使用普通解剖固定。通过比较两组在切口长度、手术时间、术中出血量、住院时间、住院费费用、膝关节功能方面的差异来分析微创下LISS钢板治疗的疗效。结果两组患者在手术切口长度、术中出血、住院时间上的差异,组间比较无统计学意义(P>0.05),但观察组在手术时间、膝关节功能(HSS值)上优于对照组,组间差异有统计学意义(P<0.05)。此外,观察组的平均住院费用明显高于对照组,组间差异亦有统计学意义(P<0.05)。结论相对于使用传统钢板治疗,双切口微创下正确使用LISS钢板治疗复杂胫骨平台骨折具有创伤小、剥离少、固定牢固等优点,可以明显改善膝关节功能,有利于膝关节功能恢复;但住院费用较高,尚需探讨解决方法。

Objective To explore the efficacy of two-incision minimally invasive LISS steel in treatment of the complex closed tibial plateau fractures （Schatzker V , VI type）. Methods According to the order of admission,37 cases of complex tibia1 plateau fractures （to Schatzker V type VI） were randomly divided into observation group （n= 22） and control group （n= 15）. All patients were given anterior cruciate lateral joint medial incision reset and fixed fractures. Obser vation group LISS plate fixation, while the control group using the ordinary anatomical fixed. By comparing the two sets of differences in incision length, operative time, blood loss, hospital stay, hospital expenses, costs, knee function to analyze the efficacy of the minimally invasive under LISS plate in the treatment. Results The differences on the length of the incision, blood loss, hospital stay between the two groups was not statistical!y significant （P〉0. 05）, but the observation group is superior to the control group on operative time, superior knee function （HSS value） control group, the difference between the groups was statistically significant （P〈0. 05）. In addition, the observation group, the average cost of hospitalization was significantly higher than that in the control group, the difference between the groups was statistically significant （P〈0.05）. Conclusion With respect to the use of traditional plate in the treatment, the two-inci-sion minimally invasive correct use LISS plate treatment of complex tibial plateau fractures with less trauma, peel less firmly fixed, etc. , which can significantly improve knee function, is conducive to the recovery of knee function.