单侧和双侧钢板内固定治疗SchatzkerⅥ型胫骨平台骨折患者的临床疗效比较

Comparison of the clinical efficacy of single and double locking compressing plates treatment for Schatzker type Ⅵ tibial plateau fractures

目的比较单侧钢板内固定与双侧钢板内固定治疗SchatzkerⅥ型胫骨平台骨折的临床疗效。方法回顾性分析我院90例SchatzkerⅥ型胫骨平台骨折患者，根据治疗方式分为单侧钢板组与双侧钢板组两组，每组各45例患者，分别行“外侧锁定加压钢板（LCP）内固定内侧螺钉辅助固定”和“内外侧双钢板内固定”手术治疗，比较两组手术时间、术中出血量、术后伤口感染，Rasmussen解剖位置评分及功能评分。结果单侧钢板组手术时间[（51．4±4．0）h、（76．2±5．5）h，（t=24．514，P〈0．001）]和术中出血量[（173．7±8．8）ml、（212．4±4．9）ml，（t-25．911，P〈0．001）]分别小于双侧钢板组．双钢板组3例患者出现伤口感染；单侧钢板组术后1年解剖位置评分和功能评分的优良率与双侧钢板组比较差异均无统计学意义（χ^2=0．442，P=0．659）。结论单侧钢板内固定治疗SchatzkerⅥ型胫骨平台骨折较双侧钢板内固定有明显优势。

Objective To compare the clinical efficacy of single and double locking compressing plates（LCP）treatment for Schatzker type VI tibial plateau fractures. Methods Patients（n=90）with Schatzker type Ⅵ tibial plateau fractures were randomly divided into two groups according to the treatment methods （single LCP group and double LCP group; 45 patients in each group） and analyzed retrospectively. Operative duration,intraoperative bleeding volume, postoperative wound infection, Rasmussen anatomical score and functional score were measured and compared between the two groups. Results More favorable results were achieved in the single LCP group than in the double LCP group in operative duration [（51.4 ±4.03）h vs. （76.2±5.5）h（t=24. 514,P〈0. 001）] and intraoperative bleeding volume[（173.7±8.8） ml vs. （ 212.4 ±4.9 ） ml （ t = 25. 911, P〈 0. 001, respectively）] . Further more, three cases of postoperative woundin fection were seen in the double LCP group, while none was observed in the single LCP group. There was no significant difference in the percentage of satisfactory Rasmussenanatomical scores and functional scores between the two groups one year afteroperation（χ^2 =- 0. 442, P= 0. 659）. Conclusions Compared with double LCP fixation, single LCP fixation is more advantageous for the treatment of Schatzker type gi tibial plateau fractures.