加味桃红四物汤结合有限内固定及外固定架术治疗胫骨平台骨折的临床观察

Therapeutic Efficacy of Modified Taohong Siwu Decoction Combined with Limited Internal Fixation and External Fixation on Tibial Plateau Fracture

【目的】探索加味桃红四物汤结合有限内固定及外固定架术治疗胫骨平台骨折SchatzkerⅤ、Ⅵ型的临床疗效,为临床提供胫骨平台骨折治疗的最佳方案。【方法】采用有限内固定结合外固定架手术,术后口服加味桃红四物汤治疗胫骨平台骨折SchatzkerⅤ、Ⅵ型患者31例。随访观察其临床疗效及术后并发症情况。【结果】全部病例获6个月~3年随访。疗效评价按照Merchant评分标准进行,其中优15例,良12例,可3例,差1例,优良率为87.1%。有1例合并钉道感染,经对症处理后痊愈。【结论】对胫骨平台骨折SchatzkerⅤ、Ⅵ型伴有皮肤条件差的患者,可予有限内固定结合外固定架治疗代替以往的广泛暴露、坚强钢板固定,并术后配合口服加味桃红四物汤,这是一种安全、有效的治疗方法,能有效促进骨折初期主要临床症状体征的缓解。

Objective To explore the therapeutic efficacy of modified Taohong Siwu Decoction（TSD）combined with limited internal fixation and external fixation for the treatment of tibial plateau fracture of Schatzker type Ⅴand Ⅵ. Methods A total of 31 cases of tibial plateau fractures of Schatzker type Ⅴ and Ⅵ treated with TSD orally combined with limited internal fixation and external fixation were enrolled into the study. Follow-up was carried out for the evaluation of therapeutic effect and postoperative complications. Results All of the cases received follow-up for 6 months to 3 years. According to Merchant scoring criteria, the therapeutic effect was excellent for 15 cases,good for 12 cases,acceptable for 3 cases and inferior for one case, with the excellent and good rate being 87.1%. One case had pin tract infection, and then was cured after symptomatic treatment.Conclusion For tibial plateau fracture of Schatzker type Ⅴ and Ⅵ with unsatisfactory skin state,we can perform limited internal fixation and external fixation to take the place of strong steel plate fixation with extensive exposure for surgical treatment,and then give postoperative oral use of TSD,which will be a safe and effective therapy for the fracture by promoting the relief of the clinical symptoms and signs of early fracture.