双切口双钢板内固定治疗复杂胫骨平台骨折的疗效分析

Analysis on curative effects of double incision double plate internal fixation in treatment of complex tibial plateau fractures

目的分析双切口双钢板内固定治疗复杂胫骨平台骨折的临床疗效。方法2015年1月~2018年1月,于我院收治的复杂胫骨平台骨折患者中选取56例,随机分为两组,对照组行单侧锁定钢板内固定治疗,观察组行双切口双钢板内固定治疗,比较两组手术情况、胫骨平台PA(后倾角)与TPA(内翻角)变化情况、并发症发生情况。结果两组术中出血量差异无统计学意义(P>0.05);与对照组比较,观察组手术时间更短,膝关节锻炼时间更早,差异有统计学意义(P<0.05);与对照组比较,观察组愈合时间、负重时间更早,组间差异有统计学意义(P<0.05);两组患者术后早期、术后12个月时的胫骨平台PA、TPA对比,差异无统计学意义(P>0.05);观察组患者并发症发生率为7.14%,明显低于对照组的28.57%,差异有统计学意义(χ2=4.383,P<0.05)。结论双切口双钢板内固定与单侧锁定钢板内固定均能有效治疗复杂胫骨平台骨折,但双切口双钢板内固定术后并发症发生率低,患者膝关节锻炼时间更早,总体应用效果更加理想,值得推广。

Objective To analyze the clinical curative effect of double incision double plate internal fixation in the treatment of complex tibial plateau fractures. Methods 56 patients with complex tibial plateau fractures who were admitted and treated in our hospital from January 2015 to January 2018, were selected and they were randomly divided into two groups. The control group was treated with unilateral locking plate internal fixation while the observation group was treated with double incision double plate internal fixation. The operation conditions, the changes of PA (posterior slope angle) and TPA (tibial plateau angle) of tibial plateau and complications were compared between the two groups. Results There was no statistically significant difference in blood loss between the two groups (P > 0.05). Compared with the control group, the operation time was shorter,the knee exercise time was earlier in the observation group, and the difference was statistically significant (P < 0.05).Compared with the control group, the healing time and weight-bearing time of the observation group were earlier, and the differences between the groups were significant (P < 0.05).There was no statistically significant difference in PA and TPA of tibial plateau between the two groups in the early postoperative period and 12 months after operation (P > 0.05).The complication rate of the observation group was 7.14%, which was significantly lower than that of the control group (28.57%). The difference was statistically significant,χ2=4.383, P < 0.05. Conclusion Double incision and double plate internal fixation and unilateral locking plate internal fixation both can effectively treat complex tibial plateau fractures. The incidence of complications after double incision double plate fixation is low, the time of knee joint exercise is earlier and the overall application effect is more ideal. Therefore, it is worthy of promotion.