锁定钢板内固定并植骨治疗复杂胫骨平台骨折的疗效分析

Analysis on the Curative Effect of Locking Plate Internal Fixation and Bone Grafting in the Treatment of Complex Tibial Plateau Fractures

目的:探讨锁定钢板内固定并植骨对于临床复杂胫骨平台骨折的治疗效果。方法:选取2008年2月-2013年2月本院收治的58例复杂性胫骨平台骨折患者作为研究对象,其中38例采用锁定钢板稳定固定并植骨治疗的患者作为观察组,20例采用传统钢板固定治疗的患者作为对照组。术后根据骨折类型及手术固定情况,早期结合CPM机、膝关节外固定支架行膝关节功能锻炼。术后平均随访15.4个月。比较两组治疗后关节功能恢复情况及术后出现关节面下沉并发症的发生率。结果:观察组手术后膝关节评分优良率为86.8%,明显高于对照组的70.0%,且观察组患者术后没有出现关节面下沉等并发症,而对照组此类并发症的发生率明显高于观察组,差异均有统计学意义(P<0.05)。结论:锁定钢板内固定并植骨治疗复杂胫骨平台骨折较传统的内固定治疗效果明显,其治愈率高,患者膝关节功能恢复好,致残率低,值得临床推广使用。

Objective： To investigate the clinical effect of locking plate internal fixation and bone grafting in the treatment of complex tibial plateau fractures.Method： 58 cases of complex tibial plateau fracture from February 2008 to February 2013 in our hospital were selected as research objects, 38 cases were treated with locking plate internal fixation and bone grafting as the observation group, 20 cases with conventional plate fixation as the control group.After operation, according to the types of fracture and fixation, early with CPM machine, knee joint external fixation support for functional exercise of knee joint.A mean follow-up of 15.4 months after the operation.The recovery of joint function and postoperative occurrence rate of complications of articular surface subsidence were compared between the two groups after treatment.Result： The excellent and good rate of knee scores in the observation group was 86.8%, it was significantly higher than the 70.0% of control group, and articular surface subsidence and other complications were no appeared, while the control group, the complication rates were significantly higher than the observation group, the differences were statistically significant （ P〈0.05 ） . Conclusion： Locking plate internal fixation and bone grafting in the treatment of complex tibial plateau fractures has a good effect, the cure rate is high, knee joint function of patients recovered well, and low morbidity, is worthy of clinical promotion.