复杂性胫骨平台骨折患者不同手术方式疗效对比

Curative effect comparison of complex tibial platform fracture treated by different operation methods

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月至2013年12月收治的70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35例患者为观察组,采用普通解剖钢板内固定治疗的35例患者为对照组.比较两组手术时间、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有统计学意义,观察组显著优于对照组（P＜0.05）;②两组术后当天、3个月和12个月的TPA和PA比较差异有统计学意义,观察组显著优于对照组（P＜0.05）;③两组膝关节功能HSS评分和优良率比较差异有统计学意义,观察组显著优于对照组（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 investigate the curative effect of ordinary anatomical plate and the locking plate on complex tibial platform fracture.Methods The clinical data of 70 patients received complex tibial plateau fracture surgery from January 2010 to December 2013 were retrospectively analyzed.Thirty-five cases received locking plate internal fixation treatment as observation group; 35 cases received 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.Results ①The differences in the operative time,intraoperative blood loss,hospitalization time,fracture healing time and limb full weight-bearing time of the two groups were significant,those in the observation group were significantly better than those in the control group （P 〈 0.05） ; ②The differences of the TPA and PA of the first day,3 months and 12 months after sugery of the two groups were significant,those in the observation group were significantly better than those in the control group （P 〈 0.05） ; ③The differences in the knee joint function HSS score and the excellent rate of the two groups were significant,those in the observation group were significantly better than those in the control group （P 〈 0.05）.Conclusions Lockingplate has better clinical curative effect on the complex tibial plateau fracture.