改良双钢板法对比微创内固定系统治疗复杂胫骨平台骨折的疗效综合评价

Efficacy evaluation of modified dual plating and less invasive stabilization system in the complex fractures of tibial plateau

目的对改良双钢板法与微创内固定系统（uss）治疗复杂胫骨平台骨折的疗效进行对比分析。方法168例复杂胫骨平台骨折患者按照治疗方法不同分为改良双钢板组（89例，采用改良双钢板法治疗）和LISS组（79例，采用LISS法治疗），对两种治疗方法的优缺点及疗效进行比较分析。结果改良双钢板组患者治疗效果优良率（89．9％，80／89）略大于LISS组患者的优良率（86．1％，68／79），两组比较差异无统计学意义（P〉0．05）。两组患者均未出现深部感染及严重的神经损害、静脉血栓等并发症。改良双钢板组手术时间（89．2±13．6）min，术中出血量（188．4±45．6）ml，住院时间（16．5±1．8）d，愈合时间（13．3±2．1）个月，LISS组手术时间（74．3±12．5）min，术中出血量（236．5±65．5）ml，住院时间（16．7±2．1）d，愈合时间（11．4±1．5）个月，两组比较差异无统计学意义（P〉0．05）。结论对于复杂胫骨平台骨折患者的治疗，LISS与改良双钢板法的治疗效果无显著差异。

Objective To evaluate the therapeutic effect of modified dual plating and less invasive stabilization system（LISS） in the complex fractures of tibial plateau. Methods One hundred and sixty-eight patients with complex fractures of tibial plateau were divided into two groups by the therapeutic methods, 89 patients were in modified dual plating group while 79 patients were in LISS group. The advantages and curative effect of two groups were retrospectively analyzed. Results The excellent and good rate in modified dual plating group was slightly higher than that in LISS group [ 89.9% （80/89） vs. 86.1% （68/79） ], and there was no significant difference （P 〉 0.05）. No patient occurred deep site infection, severe nerve damage, phlebothrombosis in two groups. In modified dual plating group, the operation time and bleeding volume was （ 89.2 ± 13.6 ） min and （ 188.4 ± 45.6） ml, the hospital stay and healing time was （ 16.5 ± 1.8 ） d and （ 13.3 ± 2.1 ） months. In LISS group,the operation time and bleeding volume was （74.3 ± 12.5） min and （236.5 ± 65.5 ） ml, the hospital stay and healing time was （16.7± 2.1 ） d and （11.4 ± 1.5 ） months. There was no significant difference （P 〉 0.05 ）. Conclusion The therapeutic effect of modified dual plating and LISS have no significant difference for complex tibial plateau fractures.