经关节截骨治疗陈旧性胫骨平台骨折内翻畸形临床效果

Clinical effect of articular osteotomy in the treatment of old tibial plateau fracture with varus deformity

目的探讨经关节截骨治疗陈旧性胫骨平台骨折内翻畸形的临床方式和效果。方法对2012年8月-2015年8月收治的96例陈旧性胫骨平台骨折内翻畸形患者,依据随机数字表法分为研究组（n=48）和对照组（n=48）。对照组患者行切开复位内固定手术治疗,研究组患者经关节截骨治疗。观察两组患者术后X线片并比较两组临床疗效。结果研究组患者的愈合时间及完全负重时间均显著短于对照组（P〈0.05）,但两组患者术后X线片的胫骨平台内翻角及后倾角之间的差异均不显著（P〉0.05）;研究组患者术后膝关节功能恢复优良率[93.8%（45/48）]显著高于对照组[66.7%（32/48）,P〈0.05]。结论经关节截骨治疗陈旧性胫骨平台骨折内翻畸形的临床效果较切开复位内固定手术好。

Objective To investigate the clinical method and clinical effect of articular osteotomy in the treatment of old tibial plateau fracture with varus deformity. Methods Ninety-six cases of old tibial plateau fracture with varus deformity in our hospital from Aug. 2012 to Aug. 2015 were selected,and divided into two groups according to random table： study group（ n = 48） and control group（ n = 48）. The control group were given open reduction and internal fixation,while the study group were given joint osteotomy. The postoperative X-ray was observed and clinical effects between the two groups were compared. Results The healing time and full weight-bearing time of the study group were significantly shorter than those of the control group（ P〈0. 05）,but the differences of the X-ray of the tibial plateau varus angle and caster angle between the two groups were not significant（ P〈0. 05）. The excellent and good recovery rate of knee function of the study group was 93. 8%（ 45 /48）,which was significantly higher than that of the control group of 66. 7%（ 32 /48,P〈0. 05）. Conclusion The clinical effect of articular osteotomy in the treatment of old tibial plateau fracture with varus deformity is better than treatment with open reduction and internal fixation.