传统切开与有限切开复位锁定钢板治疗胫骨中下段骨折临床对比研究

Clinical comparative study on traditional open and limited open reduction locking plate in the treatment of middle and lower tibial fractures

目的比较传统切开与有限切开复位锁定钢板两种方法治疗胫骨中下段骨折的临床治疗效果。方法将我院于2014年1月～2017年6月收治的52例胫骨中下段骨折患者作为研究对象。在患者及其家属知情且自愿的前提下随机分为实验组(26例)和对照组(26例)。实验组和对照组采取两种不同的治疗方法,对照组患者治疗胫骨中下段骨折的手术方法为传统切开复位锁定钢板法,实验组患者治疗胫骨中下段骨折的手术方法为有限切开复位锁定钢板。观察实验组与对照组的伤口愈合时间、术口长度、出血量;术后AOFAS踝-后足量评分、术后下地时间、骨折临床愈合时间、术后并发症以及术后优良率。结果实验组患者的伤口愈合时间、术口长度、出血量情况均低于对照组患者,差异有统计学意义(P <0.05);实验组的术后AOFAS踝-后足量评分、背伸度数均显著优于对照组患者,差异有统计学意义(P <0.05);实验组患者的术后优良率为92.3%,明显优于对照组患者的术后优良率84.6%,差异有统计学意义(P <0.05)。结论在治疗胫骨中下段骨折时使用有限切开复位锁定钢板法比使用传统切开复位锁定钢板法具有更短的伤口愈合时间以及术口长度、出血量少、术后下地时间更快、术后优良率更高等优点,有限切开复位锁定钢板法是一种适合于临床推广使用的方法。

Objective To compare the clinical curative effects of traditional open and limited open reduction locking plate in the treatment of middle and lower tibial fractures. Methods 52 patients withmiddle and lower tibial fractures who were admitted and treated in our hospital from January 2014 to June 2017 were selected as research objects. On the premise thatpatients and their families were informed and voluntarily enrolled, the patients were randomly divided into the experimental group and the control group, with 26 cases in each group. The experimental group and the control group adopt two different treatment methods.Patients in the control group were given traditional openreduction locking platemethod to treat middle and lower tibial fractures while patients in the experimental group were given limited open reduction locking plate method. The wound healing time, length of the operative wound and blood loss in the experimental group and the control group were observed. The postoperative AOFAS ankle-posterior foot scale score, postoperative leaving bed time,clinical healing time of fractures, postoperative complications and postoperative excellent and good rate were also observed.Results The wound healing time, length of the operative wound and blood loss in the experimental group were all lower than those of the control group and the difference was statistically significant(P < 0.05). The postoperative AOFASankleposterior foot scale score and back extension degree of the experimental group were both significantly better than those of the control group and the difference was statistically significant(P < 0.05).The postoperative excellent and good rate of the experimental group was 92.3%, significantly better than that of the control group 69.2%. The difference was statistically significant(P < 0.05). Conclusion Compared with traditional open reduction locking plate, limited open reduction locking plate in the treatment of middle and lower tibial fractures has advantages of shorter wound healing time and length of the operative wound, less blood loss, faster postoperative leaving bed timeand better postoperativeexcellent and good rate. The limited open reduction locking plate is suitable for clinical promotion and application.