四肢长骨干骨折治疗的有限接触动力加压钢板和动力加压钢板临床比较

Clinical comparison of dynamic compression plate and limited contact dynamic compression plate fixation in the treatment of limbs long bone fracture

目的 对比动力加压钢板（DCP）与有限接触动力加压钢板（LC-DCP）内固定治疗四肢长骨干骨折的临床疗效,为临床内固定的选择提供一定依据.方法 回顾性分析采用DCP和LC-DCP内固定治疗的172例四肢长骨干骨折患者的临床资料.其中LC-DCP组101例,DCP组71例,比较两组手术时间、术中出血量、住院时间、骨折愈合时间、骨折不愈合发生率、日常活动能力和关节功能评分及临床疗效.结果 LC-DCP组手术时间、骨折愈合时间、骨折不愈合发生率均优于DCP组[（62±13） min比（88±20） min、（60.0±20.5）d比（85.0±25.5）d、1.0％（1/101）比7.0％（5/71）],差异有统计学意义（P＜0.05）,而两组术中出血量与住院时间比较差异无统计学意义（P＞0.05）.LC-DCP组Barthel和Harris评分分别为（72.61±8.63）分和（69.28±7.63）分,均优于DCP组的（52.58±5.53）分和（55.07±6.26）分,差异有统计学意义（P＜0.05）.LC-DCP组优良率优于DCP组[99.0％（100/101）比90.1％（64/71）],差异有统计学意义（x2=15.71,P＜0.01）.结论 四肢长骨干骨折采用LC-DCP治疗,能提高临床疗效,减少手术并发症,提高患者的日常关节功能,值得临床推广使用.

Objective To compare the clinical effect of dynamic compression plate （DCP） and limited contact dynamic compression plate （LC-DCP） fixation in the treatment of limbs long bone fracture,provide certain basis for the choice of clinical internal fixation.Methods The clinical data of 172 patients with limbs long bone fracture treated with DCP and LC-DCP fixation were retrospectively analyzed.One hundred and one cases in LC-DCP group,and 71 cases in DCP group,the operation time,intraoperative blood loss,hospitalization time,fracture healing time,incidence of nonunion,daily activity ability and joint function score and clinical curative effect in two groups were compared.Results The operation time,fracture healing time,incidence of nonunion in LC-DCP group were better than those in DCP group[（62 ± 13） min vs.（88 ±20） min,（60.0 ± 20.5） d vs.（85.0 ± 25.5） d,1.0% （1/101） vs.7.0% （5/71）],there were significant differences （P 〈 0.05）,but the intraoperative blood loss and hospitalization time between two groups had no significant difference （P 〉 0.05）.Barthel and Harris score in LC-DCP group were better than those in DCP group [（72.61 ± 8.63） scores vs.（52.58 ± 5.53） scores,（69.28 ± 7.63） scores vs.（55.07 ± 6.26） scores],there were significant differences （P 〈 0.05）.The excellent rate in LC-DCP group was better than that in DCP group [99.0% （100/101） vs.90.1% （64/71）],there was significant difference （x2 =15.71,P 〈 0.01）.Conclusion Limbs long bone fracture treat with LC-DCP,can improve clinical curative effect and reduce complications,improve the daily ability of joint function in patients and is worth using in clinic.