膝关节囊外复位内固定治疗胫骨平台骨折的安全性和疗效研究

Study on the Safety and Curative Efficacy of External Fixation of Knee Joint in the Treatment of Tibial Plateau Fracture

目的探讨膝关节囊外复位内固定应用于胫骨平台骨折的优势,并分析其安全性。方法研究对象为方便选取2015年2月—2017年2月龙岩市第二医院骨科收治的发生胫骨平台骨折的124例患者。采用计算机数字随机法分为对照组(54例)与观察组(70例)。对照组采用开放关节囊直视复位内固定术,观察组采用膝关节囊外复位内固定术,对比手术情况及术后关节康复情况。结果观察组的术中出血量、切口长度均较对照组降低[(142.3±70.1)m L vs(249.8±86.4)m L][(9.3±2.3)cm vs(15.7±6.7)cm],手术时间延长[(137.6±57.1)min vs(111.3±45.2)min],差异有统计学意义(P<0.05)。两组术后骨折初步愈合时间及关节面的塌陷程度差异无统计学意义(P>0.05)。对照组优良率为66.67%,观察组优良率为85.71%,观察组明显优于对照组,差异有统计学意义(P<0.05)。结论膝关节囊外复位内固定用于胫骨平台骨折治疗,手术创伤小,避免关节囊开放后病理变化,术后关节功能恢复良好,推广意义大。

Objective This paper tries to explore the advantages and safety of knee extracorporeal external fixation in the treatment of tibial plateau fractures. Methods Convenient selection a total of 124 patients with tibial plateau fractures treated from February 2015 to February 2017 in this hospital were selected and randomly divided into the control group with 54 cases and the observation group with 70 cases by the computerized digital randomization method. The control group was treated with open joint capsule internal fixation. The observation group was treated with external fixation of knee joint, and the conditions of operation and postoperative joint rehabilitation of the two groups were compared. Results The intraoperative blood loss and incision length of the observation group were（142.3±70.1）m L and（9.3±2.3）cm, lower than those of the control group of（249.8±86.4）m L and（15.7±6.7） cm, and the operation time was prolonged [（137.6±57.1）min vs（111.3±45.2）min] respectively, so the differences were significant（P〈0.05）. There was no significant difference in the initial healing time and the degree of articular surface collapse between the two groups（ P 〉0.05）. The excellent rate was 66.67% in the control group and 85.71% in the observation group. The observation group was superior to the control group, the difference was significant（P〈0.05）. Conclusion The external fixation of knee joint for the treatment of tibial plateau fractures will result in fewer surgical traumas, avoid the pathological changes of the joint capsule, and help to recover well after operation.It is of great significance to spread around.