两种内固定法治疗胫骨近端骨折的疗效比较

Comparison of the effect of two internal fixation methods in the treatment of proximal tibial fracture

目的 比较经皮微创锁定钢板、有限接触动力加压钢板（LC-DCP）治疗胫骨近端骨折患者的临床疗效.方法 将68例胫骨近端骨折患者按数字表法随机分为对照组35例和观察组33例.观察组采用经皮微创锁定钢板固定、对照组采用LC-DCP固定.比较两组手术时间、术中出血量以及切口长度以及术后恢复情况.结果 治疗后观察组HSS评分显著高于对照组（t=6.122,P＜0.05）;观察组手术过程短、出血量少,切口小,肢体缩短情况以及膝关节屈曲度情况与对照组差异均有统计学意义（t=10.137、14.720、13.204、4.476、6.971,均P＜0.05）.观察组手术优良率为93.94%,对照组为65.71%,两组差异有统计学意义（χ^2=7.244,P＜0.05）.结论 经皮微创锁定钢板在治疗本病中的疗效优于LC-DCP,能够有效提高术后膝关节功能的恢复.另外,其还具有手术时间短、术中出血少、创伤小等优点,值得临床推广使用.

Objective To compare the curative effect of percutaneous minimally invasive locking plate,limited contact dynamic compression plate （LC-DCP） in the treatment of patients with proximal tibial fracture. Methods According to the digital table,68 patients with proximal tibial fracture were randomly divided into the control group （35 cases） and the observation group （33 cases）. The observation group was given minimally invasive percutaneous locking plate fixation, and the control group was given LC-DCP fixation. The operative time, blood loss,length of incision and postoperative recovery were compared. Results After treatment,the HSS score of the observation group was significantly higher than that of the control group （ t = 6.122, P 〈 0.05 ）. In addition, in the observation group, the op- erative time was short,the blood loss was little, the length of incision was small, and shorter limbs as well as the knee flexion had statistically significant differences compared with the control group （t = 10. 137,14.720,13. 204,4.476, 6. 971, all P 〈0.05 ）. The surgical exceUent rate of the observation group was 93.94% ,which was significantly higher than 65.71% of the control group, the difference was statistically significant between the two groups （X^2 = 7. 244, P 〈 0.05 ）. Conclusion The curative effect of percutaneous minimally invasive locking plate in the treatment of proximal tibial, fracture is better than LC-DCP, and it can improve the postoperative knee function recovery. In addition, it also has the advantages of short operation time,less intraoperative bleeding, and small trauma, which worthy of clinical using.