中西医结合治疗胫骨平台后柱骨折术后临床研究

Clinical Study of Treatment of Posterolateral Column Tibial Plateau Fracture by Combination of Traditional Chinese and Western Medicine

目的:观察膝关节后侧双入路结合中医辨证治疗胫骨平台后柱骨折术后的临床疗效。方法 :将58例胫骨平台后外侧柱骨折患者随机分为观察组和对照组,观察组38例,对照组20例。对照组采用膝关节后侧双入路对骨折进行支撑钢板内固定,观察组在对照组基础上辅以中医辨证治疗。观察两组的骨折愈合时间、肿胀程度、美国特种外科医院膝关节评分(HSS评分)和不良反应情况。结果:术后3个月观察组骨折愈合率明显高于对照组,术后7 d观察组消肿效果明显优于对照组,术后6个月及1年观察组HSS评分明显高于对照组,差异均有统计学意义(P<0.05);两组患者均无手术切口相关并发症,无感染、内固定失效及螺钉断裂等并发症发生。结论:膝关节后侧双入路结合中药治疗胫骨平台后柱骨折可缩短骨折愈合时间,减轻肿胀,促进术后膝关节功能恢复,是治疗胫骨平台后柱骨折的理想方法。

Objective：To observe the clinical effect of knee posterolateral double portal combined with syndrome differentiation of traditional Chinese medicine on posterolateral column tibial plateau fracture. Methods：fifty-eight patients with the posterolateral column tibial plateau fracture were randomly divided into observation group（n=38） and control group（n=20）. Patients in the two groups were treated with buttress plate fixation via a posterolateral approach,in the mean time,those in the observation group were given treatments based on syndrome differentiation. The fracture healing time,swelling degree,HSS score and adverse reactions of the two groups were observed. Results：Three months after the surgery,the healing rate of the observation group was significantly higher than that of the control group. Seven days after the surgery,the detumescent effect of observation group was significantly better than that of the control group. Six months and one year after the surgery,the HSS score of the observation group was significantly higher than that of the control group. All the differences were statistically significant（P〈0.05）. No complications associated with the approach were observed and there were no affection,fixation failure and screw breakage in the two groups.Conclusion：Knee posterolateral double portal combined with syndrome differentiation can shorten fracture healing time,reduce swelling and promote the recovery of the knee function. It is an ideal method for treating posterolateral column tibial plateau fracture.