牵引架结合顶棒双钢板微创治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折

Traction frame combined with top bar and double plates minimally invasion for treatment of Schatzker type Ⅴ,Ⅵ tibial plateau fractures

目的探讨牵引架结合顶棒双钢板微创治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的临床疗效。方法将40例胫骨平台SchatzkerⅤ、Ⅵ骨折患者随机分为牵引架结合顶棒双钢板微创治疗组(观察组)和传统切开复位髂骨植骨内固定组(对照组),每组20例。对比两组患者手术时间、术中出血量、住院时间、完全负重所需时间、术后6个月膝关节功能Rasmussen评分以及术后并发症。结果患者均获得随访,时间12~36个月。观察组手术时间、术中出血量、住院时间、完全负重所需时间均少于对照组,差异均有统计学意义(P<0.05)。住院时间两组比较差异无统计学意义(P>0.05)。术后6个月观察组膝关节功能Rasmussen评分优良率高于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论牵引架结合顶棒双钢板微创治疗胫骨平台骨折,膝关节可获得良好的功能恢复,并可减少术后并发症,临床效果优于传统切开复位髂骨植骨内固定。

Objective To investigate the clinical effect of Schatzker type V, VI tibial plateau fractures minimally in- vasively treated with traction frame and double-plate. Methods Forty patients with Schatzker type Ⅴ、Ⅵ fractures were divided into two groups ： the minimally invasive treatment group of double plates combined with traction rod （ ob- servation group） and the traditional open reduction and internal fixation with iliac bone graft （ control group） , with 20 cases in each group. The operative time, intraoperative blood loss, hospitalization time, time required to complete weight bearing, Rasmussen knee function scores of postoperative 6 months, and postoperative complications were compared between the two groups. Results All patients were followed up fbr 12 -36 months. The observation group of operation time, intraoperative blood loss, hospitalization time, full weight-bearing time required were significantly less than the control group, the differences were statistically significant （ P 〈 0. 05 ）, hospitalization time difference between two groups was not statistically significant （ P 〉 0. 05 ）. At 6 months of postoperation, excellent and good re- sults of knee joint of observation group was higher than that in the control group, the complication incidence rate was significantly lower than the control group, the differences were statistically significant （ P 〈 0. 05 ）. Conclusions The clinical effect of the traction frame combined with the top bar and double plates minimally invasive treatment of tibial plateau fractures is better than the traditional open reduce to take iliac bone graft internal fixation. Knee joint can get good function recovery, reduce the incidence of postoperative complications.