微创内固定系统钢板与解剖钢板治疗胫骨近端骨折疗效比较

A comparative curative effect between LISS plate and anatomical plate fixation on complicated proximal tibial fractures

目的探讨微创内固定系统(LISS)与解剖钢板在治疗胫骨近端骨折中的临床疗效差异。方法选取100例胫骨近端骨折患者,其中50例采用LISS钢板治疗作为观察组,50例采用解剖钢板治疗作为对照组。比较两组患者胫骨近端骨折后接受不同手术治疗时手术切口长度、术中出血量、手术时间、骨折愈合时间、膝关节的功能评定结果等有关数据的差异。结果在手术切口长度、术中出血量,及6个月后膝关节HSS评分比较,观察组[(9.56±2.79)cm,(125.40±62.96)m L,(80.46±7.65)分]优于对照组[(14.60±1.72)cm,(318.40±53.35)m L,(77.52±6.81)分](t=10.916,P<0.001;t=16.537,P<0.00;t=-2.024,P=0.046)。术后6个月两组患者的HSS评分定性评估:观察组优15例,良32例,可3例,差0例,对照组优5例,良40例,可5例,差0例,差异有统计学意义(χ2=6.389,P=0.041)。6个月后所有病例骨折均达到临床愈合。结论LISS具有创面小、手术疗效好等特点,可作为治疗胫骨近端骨折的治疗方法。

Objective To explore the difference in clinical efficacy in the treatment of proximal tibial fracture between less invasive sta-bilization system （LISS）and the anatomical plate fixation.Methods A hundred patients with proximal tibial fracture were assigned into two groups,the research group （50 cases）had LISS plate fixation,while the control group （50 cases）had anatomical plate fixation. The length of the incision,blood loss,operative time,fracture healing time,knee function assessment results and other relevant data be-tween the two groups were measured and compared.Results The length of the incision,blood loss and HSS scores 6 months after surgery were significantly better in LISS group [（9.56 ±2.79）cm,（125.40 ±62.96）mL,（80.46 ±7.65）scores]than those in anatomical plate group [（14.60 ±1.72）cm,（318.40 ±53.35）ml,（77.52 ±6.81）scores]（t =10.916,P 〈0.001;t =16.537,P 〈0.001;t =-2.024,P=0.046].Six months after the surgery,there were 15 excellent cases,32 good cases,3 fair cases,0 poor case in LISS group,while there were 5 excellent cases,40 good cases,5 fair cases,0 poor ease in anatomical plate fixation group.The difference between them was statisti-cally significant （χ2 =6.389,P =0.041）.A1l the cases had achieved clinical healing after 6 months of surgery.Conclusions LISS plate can yield good outcomes in the treatment of proximal tibial fractures,with less radiation exposure and a better curative effect.