胫骨平台骨折“双反”斯氏针牵引间接复位MiPPO内固定术

Needle ‘double reverse'traction reset and fixation with MiPPO for tibial plateau fractures

目的分析胫骨平台骨折予以"双反"斯氏针牵引复位、内外侧双柱锁定钢板MiPPO内固定的适应证并评价其疗效。方法我院2015年8月至2017年3月治疗31例胫骨平台骨折,按手术方式的不同分为观察组和对照组,其中观察组12例,予以"双反"斯氏针牵引复位、内外侧双柱锁定钢板MiPPO内固定术;对照组19例,予以骨折切开直接复位、锁定钢板内固定。结果观察组12例手术时间为(51.3±6.5)min、术中出血(60±8.7)mL,对照组手术时间为(68.5±6.6)min、术中出血(230±7.8)mL,观察组的手术时间和出血量较对照组明显减少,差异有统计学意义异(P<0.05)。对比术前、术后X射线片示骨折复位满意,接骨板及螺钉位置理想,无一例出现切口并发症。结论采用"双反"斯氏针牵引复位、锁定钢板MiPPO内固定术治疗Schatzker分型Ⅴ型、Ⅵ型的胫骨平台骨折临床效果良好,并发症发生率低。

Objective To analyze the indications and evaluate the efficacy of the needle to ＇ double reverse＇ traction reset,inside and outside double column locking plate internal fixation with MiPPO for tibial plateau fractures. Methods From August 2015 to March 2017 ,a total of 31 patients with tibial plateau fractures in our hospital were divided into treatment group and control group. The treatment group with 12 cases were treated with the needle to be ＇double reverse＇ traction reset,inside and outside double column locking plate MiPPO fixation. The control group with 19 cases received open reduction and internal fixation with locking plate. Results In treatment group,the operation time was （51.3 ±6.5 ）minutes, the intraoperative bleeding was （60 ±8.7 ）mL. In the control group, the operation time was （68.5 ±6.6 ）minutes, the intraoperative bleeding was （ 230 ± 7.8 ） mL. The operation time and blood loss of treatment group were less than those of control group,the differences were statistically significant（ P 〈 0.05 ）. The postoperative X ray film of fracture showed that the bone plate and screw position were ideal compared with those before operation,no complication occurred. Conclusion The needle ＇ double inverse＇ traction and locking plate MiPPO fixation treatment have good clinical effect for patients of Schatzker Ⅴ, Ⅵ tibia platform fracture, with less complication.