微创经皮锁定钢板治疗GustiloⅡ型胫骨开放骨折的疗效观察

Minimally invasive locking plate in the treatment of gustilo type Ⅱ open tibial fractures

目的:观察锁定钢板一期治疗GustiloⅡ型胫骨开放性骨折的临床效果。方法:选取2015年1月至2018年1月我院收治的GustiloⅡ型胫骨开放性骨折患者64例。按照治疗方法分为观察组和对照组,每组32例。观察组采用锁定钢板螺钉内固定,对照组采用外固定支架固定。比较两组患者伤口愈合时间,骨折愈合时间以及术后膝踝关节功能恢复情况,采用Johner-Wruhs评分标准进行功能评定。结果:平均随访时间(25±1.5)个月,观察组在胫骨骨折愈合时间、膝踝关节功能恢复、部分负重时间等方面优于对照组(P<0.05)。两组患者的优良率分别为94%、82.4%,两组患者伤口愈合时间差异无统计学意义(P>0.05)。结论:锁定钢板治疗GustiloⅡ型胫骨开放性骨折手术时间短,复位优良,临床愈合效果好。

Objective： To observe the clinical effect of locking plate in the treatment of open tibial fracture of type Gustilo Ⅱ. Methods： From January 2015 to January 2018,64 patients with Gustilo Ⅱ open tibial fracture were collected. They were divided into two groups according to the treatment method,32 cases in each group. The observation group was treated with locking plate and screw fixation while the control group was fixed with external fixator. Wound healing time,fracture healing time and postoperative knee and ankle function recovery were compared between the two groups. Johner-Wruhs score was used to evaluate the function. Results：The follow - up time ranged from 12 to 36 months. The functional recovery of knee and ankle joint,partial weight-bearing time and healing time of tibial fracture in the observation group were better than those in the control group（P〈0.05）. The excellent and good rates of the two groups were 94.0% and 82.4V respectively. There was no significant difference in wound healing time between the two groups（ P〉0.05 ）. Conclusion：Locking plate for Gustilo type Ⅱ open tibial fractures has the advantages of short operative time, good reduction and good clinical healing.