普通解剖钢板和锁定钢板治疗复杂性胫骨平台骨折疗效对比

Comparison of curative effect of ordinary anatomical plate and locking plate in the treatment of complicated fracture of tibial plateau

目的 探讨采用普通解剖钢板和锁定钢板治疗复杂性胫骨平台骨折的临床疗效.方法 回顾性分析2008年4月～2012年4月收治的50例复杂胫骨平台骨折手术患者的临床资料,其中采用锁定钢板治疗的22例患者作为观察组;采用普通解剖钢板内固定治疗的28例患者作为对照组.比较两组的手术时间、术中失血量、住院时间、骨折愈合时间、患肢完全负重时间、胫骨平台内翻角（TPA）和后倾角（PA）变化、膝关节功能HSS评分、优良率及术后并发症.结果 两组在手术时间、术中出血量、住院时间、骨折愈合时间和患肢完全负重方面比较差异无统计学意义（P＞0.05）;两组术后当天、3个月和12个月的TPA、PA比较差异无统计学意义（P＞0.05）;两组的膝关节功能HSS评分及优良率比较差异无统计学意义（P＞0.05）.结论 锁定钢板内固定与普通解剖钢板治疗复杂性胫骨平台骨折的临床疗效相近,临床中应根据患者实际情况选择恰当的方法.

Objective To explore the curative effect of ordinary anatomical plate and locking plate in the treatment of complicated fracture of tihial plateau. Methods Clinical data of 50 cases who underwent surgery for complicated fracture of tibial plateau from April, 2008 to April, 2012 were retrospectively analysed. 22 cases treated by locking plate were selected as the observation group and 28 treated by ordinary anatomical plate as the control group.Then, the operation time, blood loss during operation, duration of hospital stay, fracture healing time, the time that the fractured limb can bear full weight, the change of tibial plateau varus angle（TPA） and caster angle （PA）, HSS score of knee joint function,excellent rate and postoperative complications of the two groups were compared.Results No significant difference was found in the operation time, blood loss during operation, duration of hospital stay, fracture healing time and the time that the fractured limb can bear full weight between two groups（ P 〉0.05）.There were neither significant differences in TPA and PA of the first day, the 3rd month and 12th month after sugery（ P 〉0.05）.Their HSS scores of knee joint function and excellent rates also showed no significant statistical difference between two groups （ P 〉0.05）.Conclusion Locking plate has a similar clinical curative effect with ordinary anatomical plate in the treatment of the complex tibial plateau fracture.So appropriate treatment should be adopted according to the clinical situation of patients.