内固定术后中医辅助疗法对复杂胫骨平台骨折疗效观察

Traditional Chinese Medicine Therapy after Internal Fixation for Complex Tibial Plateau Fracture

目的:探讨采取漂浮体位下的三柱内固定治疗复杂胫骨平台骨折后,中医辅助疗法对于患者术后的临床疗效。方法:选取医院2013年6月—2014年12月收治的复杂胫骨平台骨折患者46例,所有患者均为三柱骨折。让患者采取漂浮体位,采用三柱内固定术进行治疗,联合肌肉康复训练,将患者按照最小不平衡指数法分为观察组和对照组,每组各23例,其中对照组在术后采用传统的康复治疗,观察组在术后传统的康复治疗基础上再给予中医辅助疗法,最后,对每组患者在术后的各项相关指标值进行观察和评价,在患者术后一年进行随访,检查了解患者骨折愈合情况及膝关节功能恢复情况。结果:对照组患者术后恢复愈合时间(14.8±0.5)周,较短于对照组的(18.6±2.3)周;对照组术后1年HSS评分为(95.4±0.7)分,多于对照组的(81.5±0.5)分;对照组膝关节活动度为(134±0.8)°,大于对照组的(112±0.7)°;治疗疗效的优良率比较,观察组为91.3%,要高于对照组的69.6%,差异均具有统计学意义(P<0.05),46例患者无一例出现骨折不愈合、感染、内固定松动等不良临床表现。结论:中医辅助疗法应用于复杂胫骨平台骨折三柱内固定术后的治疗,可缩短患者术后骨折的愈合时间,提高骨折术后的恢复疗效,提高HSS的评分及疗效的优良率。

Objective：To discuss the clinical efficacy of traditional Chinese medicine adjuvant therapy after taking three - column floating position of internal fixation for the treatment of complex tibial plateau fractures. Methods ： During June 2013-December 2014,46 patients with complex tibial plateau fractures were treated in our hospital. All patients were three - column fractures. The patients took floating position and used the three - column internal fixation. The patients according to the minimum balance index were divided into the observation group and the control group, each with 23 ca- ses. The control group was used the traditional rehabilitation therapy after operation and the observation group added adju- vant therapy of traditional Chinese medicine based on the traditional rehabilitation treatment. Finally, in each group after operation,the patients＇ relevant index values were observed and evaluated. After one year follow -up, examine patients＇ fracture healing and knee joint function recovery. Results ： Recovery time after operation in control group were （ 14.8 ±0.5 ） weeks, shorter than the control group＇ s （ 18.6 ± 2.3 ） weeks. In the control group, the HSS score was （95.4 ± 0.7） in 1 year and more than the control group＇s （81.5 ±0.5）. The activity of the control group was （134 ±0.8） and was higher than the control group＇ s （ 112 ± 0.7 ）. The good rate of the observation group was 91.3%, higher than the control group ＇ s 69.6%. The difference was statistically significant （P 〈 0.05 ）. Forty - six cases were without a fracture nonun- ion,infection,internal fixation loosening or other adverse clinical manifestations. Conclusions：Traditional Chinese medi- cine auxiliary therapy inthe treatment of complex tibial plateau fractures can shorten the healing time. The method can improve the recovery effect after operation and improve the HSS score and the excellent rate of curative effect.