胫骨平台骨折手术治疗失败的原因分析

Analysis of Causes of Treatment Failure of Tibial Plateau Fracture Surgery

目的探讨胫骨平台骨折手术治疗失败的原因。方法方便选取2013年1月—2016年9月该院收治的45例胫骨平台骨折手术治疗患者为研究对象,根据手术治疗结果将病例分为两组。实验组14例,患者手术失败,对照组31例,患者手术成功。回顾性分析两组病史及影像学资料,评估两组固定方法、复位质量及功能锻炼情况等,观察手术失败原因。结果实验组不成熟时机下手术3例(21.4%),内固定选择欠佳2例(14.3%)、塌陷的关节面未予植骨4例(28.6%)、术后功能锻炼不当5例(35.7%),各项指标与对照组比较差异有统计学意义(P<0.05),是导致胫骨平台骨折手术失败的主要因素。结论导致胫骨平台骨折手术治疗失败的原因复杂,根据实际病症及治疗需要制定合适的手术计划、选择适当的内固定系统、术后正确的功能锻炼是手术成功的关键。

Objective To study the causes of treatment failure of tibial plateau fracture surgery. Methods 45 cases of patients with tibial plateau fracture surgery admitted and treated in our hospital from January 2013 to September 2016 were convenient selected and divided into two groups according to the operation treatment results, the operation of 14 cases in the experimental group was failure, and the operation of 31 cases in the control group was successful, and the disease history and imaging data were reviewed and the fixation method, reset quality and functional exercise of the two groups were evaluated and the causes of operation failure were observed. Results In the experimental group, there were 3 cases whose operation opportunity was not mature(21.46%), 2 cases whose internal fixation selection was poor(14.3%), 4 cases with no bone grafting of collapsed articular surface(28.6%)and 5 cases with improper functional exercises after surgery(35.7%),and the differences in various indexes between the two groups were statistically significant(P <0.05), and they were the major factors of failure of tibial plateau fracture surgery. Conclusion The causes of failure of tibial plateau fracture surgery is complex, and we need to make the proper operation plan and select the proper internal fixation system according to the practical diseases and treatment, and the accurate functional exercise after surgery is the key to the successful operation.