锁定钢板内固定术与常规解剖钢板内固定术治疗胫骨平台复杂性骨折的临床疗效比较研究

Comparative effectiveness research of locking plate internal fixation and conventional anatomical plate internal fixation in treating tibial plateau complicated fracture

目的比较锁定钢板内固定术与常规解剖钢板内固定术治疗胫骨平台复杂性骨折的临床疗效。方法选取攀枝花市盐边县人民医院2013年6月—2015年10月收治的胫骨平台复杂性骨折患者184例,根据随机数字表法分为对照组和研究组,各92例。对照组患者采用常规解剖钢板内固定术治疗,研究组患者采用锁定钢板内固定术治疗。比较两组患者住院时间、手术时间、术中出血量、骨折愈合时间及完全负重时间,术后当日、术后3个月及术后12个月胫骨平台内翻角、胫骨平台后倾角,膝关节功能疗效及并发症发生情况。结果两组患者住院时间、手术时间、术中出血量、骨折愈合时间、完全负重时间比较,差异无统计学意义(P>0.05)。术后当日、术后3个月及术后12个月,两组患者胫骨平台内翻角、胫骨平台后倾角比较,差异无统计学意义(P>0.05)。两组患者膝关节功能疗效、并发症发生率比较,差异无统计学意义(P>0.05)。结论采用锁定钢板内固定术与常规解剖钢板内固定术治疗胫骨平台复杂性骨折的临床疗效相当,在术式遴选上需综合考量。

Objective To compare the clinical effect of locking plate internal fixation and conventional anatomical plate internal fixation in treating tibial plateau complicated fracture. Methods A total of 184 cases of tibial plateau complicated fracture patients were selected from June 2013 to October 2015 in Yanbian County People＇ s Hospital of Panzhihua City,which were divided into control group and study group according to the random number table method,92 cases in each group. Control group was treated with conventional anatomical plate internal fixation,study group was treated with locking plate internal fixation. The hospitalization time,operation time,intraoperative blood loss,fracture healing time,complete weight-bearing time were compared between the two groups,and the tibial plateau angle,tibial plateau and posterior inclination in the day of operation and after operation of 3,12 months,and knee joint function effect and complications were compared between the two groups. Results No statistically significant differences of hospitalization time,operation time,intraoperative blood loss,fracture healing time or complete weight-bearing time was found between the two groups（ P〉0. 05）. In the day of operation and after operation of 3,12 months,no statistically significant differences of tibial plateau angle,tibial plateau and posterior inclination was found between the two groups（ P〉0. 05）. There was no significant differences of knee joint function effect or the incidence rate of complications（ P〉0. 05）. Conclusion Locking plate internal fixation in treating tibial plateau complicated fracture is equivalent to conventional anatomical plate internal fixation,so the choice of surgical procedure is considered.