双切口双钢板内固定术治疗胫骨平台复杂骨折的效果分析

Analysis of the effect of double incision double plate internal fixation in the treatment of complex fractures of tibiai plateau

目的研究双切口双钢板内固定术治疗胫骨平台复杂骨折的临床疗效和安全性。方法按治疗方法的不同，将83例胫骨平台复杂骨折患者分成双钢板组（51例）与锁定钢板组（32例），比较两组的手术指标、治疗疗效以及并发症发生情况。结果观察组的负重时间、住院时间以及骨折愈合时间明显短于对照组[（9．36±2．14）d比（13．24±2．99）d，（11．71±1．32）d比（13．41±2．23）d，（13．27±1．83）周比（15．82±2．18）周]，两组差异均有统计学意义（t=6．813、4．368、5．736，均P〈0．05）；观察组、对照组的膝关节功能评分表（HSS）评分优良率分别是94．12％、93．75％，差异无统计学意义（χ^2=0．746，P〉0．05）；观察组的并发症发生率明显低于对照组（5．88％比21．88％），差异有统计学意义（χ^2=4．746，P〈0．05）。结论双切口钢板内固定手术治疗胫骨平台复杂骨折疗效好，术后恢复快，安全性高，值得在临床进行推广应用。

Objective To study the clinical efficacy and safety of double incision double plate internal fixation in the treatment of complex fractures of tibial plateau. Methods According to the different treatment methods, 83 patients with tibial plateau complex fractures were divided into double plate group （51 cases） and locking plate group（ 32 cases ）. The surgical indicators, treatment efficacy and complications were compared between the two groups. Results The time of implantation, hospital stay and fracture healing time in the observation group were signif- icantly shorter than those in the control group [ （9.36 ± 2.14） d vs. （ 13.24 ± 2.99） d; （ 11.71 ± 1.32） d vs. （ 13.41 ± 2.23 ） d ; （ 13.27 ± 1.83 ） weeks vs. （ 15.82 ± 2.18 ） weeks ], the differences were statistically significant （t =6.813,4.368,5. 736 ,all P 〈 0.05 ）. The excellent rates of HSS score in the observation group and the control group were 94.12% and 93.75%, respectively, and there was no statistically significant difference （ χ^2 = 0. 746, P 〉 0.05）. The incidence rate of complications in the observation group was significantly lower than that in the control group （ 5.88 % vs. 21.88 % ） （ χ^2 = 4.746, P 〈 0.05 ）. Conclusion Double - incision plate internal fixation surgery for tibial plateau complex fractures is effective,has fast postoperative recovery,high safety, and it is worthy of clinical application in a wide range of popularization.