矫枉过正复位法结合内固定治疗胫骨平台骨折的效果研究

Study on the effect of internal fixation in treatment of tibial plateau fracture with the reduction of overkill

目的探讨胫骨平台骨折矫枉过正复位法结合内固定手术治疗的效果。方法在本院2010年3月至2016年9月接诊的胫骨平台骨折患者中,40例患者,在塌陷骨折块解剖复位的基础上,矫枉过正复位,垫高2~3 mm,结合内固定手术治疗,作为研究组。另外40例常规解剖复位内固定治疗,作为对照组,观察记录两组患者临床效果、关节面复位不良率,再塌陷率,并采取统计学软件SPSS 18.0分析。结果两组患者治疗后均可评价疗效,根据Merchant评分评价疗效,显示研究组得分为90.0±4.1分,显著高于对照组83.5±5.5分(P<0.05);研究组骨折复位不良率、再塌陷率,分别为2.50%、2.50%,低于对照组的12.50%、15.00%,其中再塌陷率差别具有显著性(P<0.05)。结论对于胫骨平台塌陷骨折采用手术治疗的患者,手术中将塌陷骨折块过度复位2~3 mm,不仅能提高复位成功率,降低再塌陷率,还能提高Merchant评分效果,值得推广。

Objective To investigate the effect of surgical treatment of tibial plateau combined with excessive reduction and internal fixation.Methods 40 cases of patients diagnosed as tibial plateau fracture were in our hospital in March 2010 ~ 2016 year in September,these cases took collapse fracture 2 ~ 3 mm excessive reduction on the basis of anatomical reduction combined with internal fixation. Other 40 cases with tibial plateau were treated as the control group accepted conventional fixed reduction and internal treatment,the clinical effect of two groups of patients were observed and recorded. The incidence rates of fracture mal-reduction,and recollapse rate were analyzed with statistical software SPSS18. 0. Results The two groups of patients after treatment were evaluated according to Merchant score,curative effect evaluation,study group mean scores was90.0±4.1,significantly higher than the control group 83.5±5.5（ P〈0.05）; the study group the incidence of malreduction,recollapse of joint surface were 2. 50%,2. 50%,significantly lower than the control group 12. 50%,15.00%（ P〈0.05）. Conclusions For the surgical treatment of fracture of tibia plateau were treated by surgery collapse,collapse fracture block over reset 2 ~ 3 mm,can not only maintain the excellent reduction,but also improve the Merchant score with low collapse of joint surface rate,worthy of reference.