开窗夯实植骨和填塞植骨治疗胫骨平台骨折对比研究

A contrastive study of the clinical effects between openning the window ramming bone graft and packing bone graft in patients with tibial plateau fracture

目的对比开窗夯实植骨和填塞植骨两种方法对胫骨平台骨折的临床治疗效果。方法选择胫骨平台骨折患者104例,以数字表法随机分为两组,分别给予开窗夯实植骨术(开窗夯实植骨组,n=52)与填塞植骨术治疗(填塞植骨组,n=52),比较两组患者治疗效果、骨痂出现时间、骨折愈合时间、完全负重时间、术后并发症发生率以及膝关节Rasmussen评分。结果开窗夯实植骨组治疗优良率为84.6﹪,高于填塞植骨组的53.8﹪,差异具有统计学意义(P<0.05);开窗夯实植骨组患者骨折愈合时间、完全负重时间分别为(4.3±0.5)个月、(9.5±0.9)周,均短于填塞植骨组的(5.8±0.4)个月、(11.2±0.8)周,差异具有统计学意义(P<0.05);术后第9个月开窗夯实植骨组膝关节Rasmussen评分为(29.2±0.9)分,高于填塞植骨组的(21.1±0.8)分,差异具有统计学意义(P<0.05);开窗夯实植骨组并发症发生率为3.8﹪,低于填塞植骨组的28.8﹪,差异具有统计学意义(P<0.05)。结论开窗夯实植骨治疗胫骨平台骨折疗效显著,术后膝关节功能恢复更理想,并发症发生率低,值得推广。

Objective To compare the clinical effects of openning the window ramming bone graft and packing bone graft in patients with tibial plateau fracture. Methods 104 patients with tibial plateau fracture were randomly divided into the openning window ramming bone graft group（n=52） and the packing bone graft group（n=52）, then the treatment effects,callus appeared time,fracture healing time,full weight-bearing time,complication rate and Rasmussen scores of the knee were compared between the two groups. Results The excellent rate was 84.6﹪ in the openning window ramming bone graft group, significantly higher than 53.8﹪ in the packing bone graft group（P〈0.05）. The bone healing time and the full weight-bearing time in the openning window ramming bone graft group were（4.3±0.5）months and（9.5±0.9）weeks,significantly shorter than（5.8±0.4） months and（11.2±0.8）weeks in the packing bone graft group（P〈0.05）. 9 months after the operation, the Rasmussen scores of the knee in the openning window ramming bone graft group was 29.2±0.9,significantly higher than 21.1±0.8 in the packing bone graft group（P〈0.05）. The complication rate was 3.8﹪ in the openning window ramming bone graft group,significantly lower than 28.8﹪ in the packing bone graft group（P〈0.05）. Conclusion Openning the window ramming bone graft has exactly effective in the treatment of tibial plateau fracture,with more satisfactory postoperative recovery of joint function and low complication rate,it＇s worthy of promotion.