胫骨平台骨折切开复位内固定术的临床效果观察

The clinical efficacy observation of incision restoration and internal fixation for tibial plateau fracture

目的 观察并且分析切开复位内固定术治疗胫骨平台骨折的临床效果。方法 将2012年4月至2015年7月我院收治的100例胫骨平台骨折患者作为研究对象,随机将其分作观察组和对照组,各50例。观察组采取切开复位内固定术,对照组给予手法复位骨外固定架进行固定,随访6～12个月,对两组患者的治疗优良率及并发症的发生情况进行对比分析。结果 观察组治疗痊愈32例,显效14例,有效3例,未愈1例,总显效率为92.00%;对照组治疗痊愈18例,显效18例,有效9例,未愈5例,总显效率为72.00%。观察组总显效率明显高于对照组（χ^2=6.7751,P＜0.01）。并发症方面,观察组术后关节不稳1例,关节僵直1例,骨折延迟愈合1例;对照组术后关节不稳2例,关节僵直3例,骨折延迟愈合2例,创伤性关节炎2例,畸形愈合3例;观察组并发症明显少于对照组（χ^2=6.3529,P＜0.05）。结论 胫骨平台骨折患者采取切开复位内固定术治疗具有临床效果显著、并发症少等优点,具有很好的临床应用价值。

Objective To observe and analyze the clinical effect of incision restoration and internal fixation for tibial plateau fracture. Methods One hundred cases of patients with tibial plateau fracture admitted in our hospital from April 2012 to July 2015 were selected and divided into observation group and control group. The 50 cases of observation group were given open reduction and internal fixation, while the 50 cases of control group were given external skeletal fixation. The excellence rates and complications were evaluated after 6-12 months follow-up. Results in the observation group, 32 cases were cured, 14 cases were excellent, 3 cases were effective, 1 case was ineffective, and the total excellent rate was 92.00%. In control group, 18 cases were cured, 18 cases were excellent, 9 cases were effective, 5 cases were ineffective, and the total excellent rate was 72.00%. The excellent rate in the observation group was significantly higher than that in the control group （x^2=6.7751, P〈0.01）. In the observation group, there were joint instability for 1 case, joint ankylosis for 1 case and delay fracture healing for 1 case. In the control group, there were joint instability for 2 cases, joint ankylosis for 3 cases, delay fracture healing for 2 cases, traumatic osteoarthritis for 2 cases, and malformed cicatrisation for 3 cases. The incidence rate of complication in the observation group was lower than that in the control group （x^2=6.3529, P〈0.05）. Conclusion Incision restoration and internal fixation have a remarkable clinical effect in the treatment of patients with tibia1 plateau fracture, with fewer complications.