复杂胫骨平台骨折52例手术时机与手术方式选择及疗效分析

Operative opportunity and operative methods selection and curative effect analysis of 52 cases of complex tibial plateau fractures

目的:探析复杂胫骨平台骨折手术时机与手术方式选择及疗效。方法:收治复杂胫骨平台骨折患者52例,随机平分为两组。1组接受膝前外侧单切口单钢板法治疗,2组接受膝前正中切口双钢板法治疗,对两组临床治疗效果进行对比分析。结果:两组患者在术中出血量、骨折愈合时间、内固定失败率上差异有统计学意义(P<0.05);受伤后4~5 d接受手术患者的并发症发生率较受伤后3 d内手术患者低(P<0.05),受伤后6~8 d手术患者的并发症发生率较受伤后0~5 d和9 d以上患者低(P<0.05)。结论:复杂腔骨平台骨折患者接受手术的最佳时机为受伤后6~8 d,手术方式需要根据患者的实际情况决定,但膝前正中切口双钢板法的治疗效果更佳。

Objective:To study the operation opportunity of complex tibial plateau fracture and the choice of operation mode andits curative effect.Methods:52patients with tibial plateau fracture were selected.They were randomly divided into the two groupson average.The1group received single anterolateral knee single incision single plate method.The2group received anteriormedian incision double plate method.The clinical treatment effect of the two groups were compared and analyzed.Results:Therewere differences in the amount of bleeding,fracture healing time and internal fixation failure rate between groups(P<0.05).Thecomplication rate of4～5d after the injury was lower than that of3d after the injury(P<0.05);the incidence of complications inpatients after surgery of6～8d after the injury was lower than that of0～5d and more than9d after the injury(P<0.05).Conclusion:The best time for patients with complicated tibial plateau fractures with surgery is6～8d after injury.The operationmode should be decided according to the actual situation of the patient,but the double plate method of anterior median incision ofthe knee is better.