不同修复方案对胫骨内侧平台骨折合并外侧副韧带损伤术后膝关节功能的影响分析

Analysis of Effect of Different Repair Plans on the Knee Joint Function after the Internal Tibial Plateau Fracture and Lateral Ligaments of Ankle Joint Surgery

目的研究不同方法修复胫骨内侧平台骨折合并外侧副韧带损伤对患者膝关节功能的影响。方法方便选取该院2014年11月—2015年11月期间所收治的骨折患者30例作为该次研究对象,根据患者的副韧带是否完全断裂分为两组,将患者分为副韧带完全断裂(n=16)与非完全断裂(n=14)。待患者骨折手术复位后,对两组患者再次进行分组,均分为支具组与石膏组,两组患者分别进行修复后,应用RASMUSSEN评分对患者的膝关节功能进行评分。结果韧带非断裂患者中支具组的伸膝(4.99±1.23)分以及膝关节稳定性评分(4.87±1.63)分均高于石膏组(3.02±1.24)分、(3.01±1.44)分,两组差异有统计学意义(P<0.05);两组在疼痛、膝关节活动度、行走能力与RASMUSSEN总分方面差异无统计学意义(P>0.05);韧带断裂患者中支具组的膝关节活动度(4.93±1.28)分以及行走能力评分(4.87±1.73)分均高于石膏组(3.14±1.45)分、(3.20±1.12)分,两组差异有统计学意义(P<0.05),疼痛、伸膝、膝关节稳定性与RASMUSSEN总分差异无统计学意义(P>0.05)。结论两种修复方式各有特点,在临床治疗中,应该对胫骨内侧平台骨折合并外侧副韧带损伤患者的损伤程度进行分析,待分析全面后,确定修复方案。

Objective To research the effect of different repair plans on the knee joint function after the internal tibial plateau fracture and lateral ligaments of ankle joint surgery. Methods Convenient selection 30 cases of fracture patients admitted and treated in our hospital from November 2014 to November 2015 were selected and divided into two groups according to whether the accessory ligament was totally fracture, including complete fracture group（n =16）and incomplete fracture（n=14）, and the patients were divided into groups again after the fracture surgery reset, both the orthosis group and the plaster group were repaired, and then the knee joint function was scored by the RASMUSSEN score. Results The extension of the knee joint and stability of knee joint score in the incomplete fracture group were higher than those in the plaster group[（4.99±1.23）points,（4.87±1.63）points vs（3.02±1.24）points,（3.01±1.44）points], and the differences were statistically significant（P〈0.05）, and the differences in the pains, knee joint activity degree, walking ability and total score of RASMUSSEN were not obvious without statistical significant（P〈0.05）, and the knee joint activity degree and walking ability score in the orthosis group were higher than those in the plaster group[（4.93±1.28）points,（4.87±1.73）points vs（3.14±1.45）points,（3.20 ±1.12）points], and the difference was obvious with statistical significant（P〈0.05）, and the differences in the pains, extension of the knee joint, stability of knee joint and total score of RASMUSSEN were not statistically significant（P〈0.05）. Conclusion Each repair method has own features, and we should analyze the injury degree of patients with internal tibial plateau fracture and lateral ligaments of ankle joint in clinical treatment and ensure the repair plan after the comprehensive analysis.