锁定钢板治疗复杂性胫骨平台骨折患者的临床研究

The Clinical Research of Complex Tibial Platform Fracture Treated by Locking Plate Operation Method

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2010年1月-2013年12月本院收治的60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患者30例作为观察组;采用普通解剖钢板内固定治疗的患者30例作为对照组。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评分和优良率及术后并发症。结果:(1)观察组手术时间、术中出血量、住院时间、骨折愈合时间和患肢完全负重方面均显著优于对照组,差异均有统计学意义(P<0.05);(2)观察组术后3个月和12个月的TPA和PA均显著优于对照组,差异有统计学意义(P<0.05);(3)观察组的膝关节功能HSS评分和优良率显著优于对照组,差异有统计学意义(P<0.05)。结论:锁定钢板内固定治疗复杂性胫骨平台骨折与普通解剖钢板临床疗效相比,有显著优势。

Objective： To explore the curative effect of complex tibial platform fracture treated by ordinary anatomical plate and the locking plate. Method： The clinical data of 60 patients who received complex tibial plateau fracture surgery from January 2010 to December 2013 were make retrospectively analysis. 30 patients used locking plate internal fixation treatment as observation group ; 30 patients used common anatomic plate internal fixation treatment as control group. The operation time, intraoperative blood loss, hospital stay, fracture healing time, limb full weight- bearing time, tibial plateau varus Angle （ TPA ） and caster Angle （ PA ）, knee joint function HSS score and the excellent rate , postoperative complications of the two groups were compared. Result： （ 1 ） The difference in the operative time, intraoperative blood loss, hospitalization time, fracture healing time and limb full weight-bearing time of the two groups had statistical significance , the observation group was significantly better than the control group （ P〈0.05 ） ; （ 2 ） The difference of the TPA and PA of the 3 months and 12 months after surgery of the two groups had statistical significance , the observation group was significantly better than the control group （ P〈0.05 ） ; （ 3 ） The difference in the knee joint function HSS score and the excellent rate of the two groups had statistical significance , the observation group was significantly better than the control group （ P〈O.05 ） . Conclusion： Locking plate has a better clinical curative effect with normal anatomic plate in the treatment of the complex tibial plateau fracture.