单、双侧钢板内固定术治疗复杂胫骨平台骨折的效果对比

Effect comparison of internal fixation with single or double side plate for the treatment of complex tibial plateau fracture

目的比较单、双侧钢板内固定术治疗复杂胫骨平台骨折的临床效果。方法选取本院2009年1月-2012年12月收治的复杂胫骨平台骨折患者42例．随机分为观察组与对照组。每组各2l例。观察组患者应用外侧解剖锁定加压钢板（LCP）内固定术治疗，对照组患者应用内外侧双钢板内固定术治疗。比较两组患者的手术时间、骨折愈合时间、膝关节活动范围及膝关节功能。结果术后32周内，所有患者的骨折均愈合良好，未发生骨不连，对照组患者出现3例胫内侧皮肤坏死、骨外露。经过负压引流治疗后创面愈合，观察组患者未出现上述并发症，两组比较，差异有统计学意义（P〈0．05）；两组患者的手术时间、骨折愈合时间、膝关节活动范围、膝关节功能优良率比较，差异无统计学意义（P〉0．05）。结论单、双侧钢板内固定术治疗复杂胫骨平台骨折均可以取得良好的临床效果，单侧内固定可以显著降低术后皮肤坏死、骨外露的发生率。

Objective To analyze the clinical effect of internal fixation with single or double side plate for the treat- ment of complex tibial plateau fracture effect comparisoneffect comparisoneffect comparison. Methods 42 patients with complex tibial plateau fracture were selected in our hospital from January 2009 to December 2012 and they were ran- domly divided into the observation group （n=21） and the control group （n=21）.Patients in the observation group were treated with lateral anatomic locking compression plate （LCP）,while patients in the control group were treated with the internal fixation of inside and outside side of double plate. The operative time,healing time of fracture,activity range of knee joint,knee joint function of the two groups were compared. Results Fracture of patients healed well in 32 weeks after operation without bone nonunion,3 patients in the control group appeared skin necrosis of medial tibial,bone ex- posure,and the wound healed up after the treatment of negative pressure drainage,patients in the observation group had no above-mentioned complications,and there was a statistical difference between the two groups （P〈0.05）;There was no statistical difference of the operative time,healing time of fracture,activity range of knee joint,excellent and good rate of knee joint function in the two groups （P〉0.05）. Conclusion Using internal fixation of single or double side plate to treat complex tibial plateau fracture can achieve good clinical effect and unilateral internal fixation can significantly reduce incidence rate of skin necrosis and bone exposure after operation.