双切口双钢板内固定与单侧锁定钢板内固定修复复杂胫骨平台骨折的临床比较研究

Clinical comparison of double-incision double-plate internal fixation and unilateral locking plate internal fixation for the repair of complex tibial plateau fractures

目的比较单侧锁定钢板与双切口双钢板两种内固定方式修复复杂胫骨平台骨折的临床疗效。方法选取2017年11月-2018年12月期间在我院接受治疗的复杂胫骨平台骨折患者80例,采用随机数字表法将其分为单侧锁定钢板组(40例)和双切口双钢板组(40例)。单侧锁定钢板组行单侧锁定钢板内固定术,双切口双钢板组行双切口双钢板内固定术,记录2组患者的围术期指标和术后并发症情况,采用Rasmussen膝关节功能评分量表评估患者的膝关节功能优良率。结果双切口双钢板组下地负重时间和骨折愈合时间均短于单侧锁定钢板组(P<0.05);2组患者手术时间、术中出血量比较无统计学差异(P>0.05);双切口双钢板组术后并发症发生率低于单侧锁定钢板组(P<0.05);2组治疗优良率比较无统计学差异(P>0.05)。结论两种手术在治疗复杂胫骨平台骨折中均能取得较好疗效,但双切口双钢板内固定术能更有效地缩短患者骨折愈合时间和下地负重时间,且并发症发生率较低。

Objective To compare the clinical efficacy of double-incision double-plate internal fixation and unilateral locking plate internal fixation for the repair of complex tibial plateau fractures.Methods 80 patients with complex tibial plateau fractures who were treated in our hospital from November 2017 to December 2018 were enrolled.They were divided into unilateral locking plate group(40 cases)and double-incision double-plate group(40 cases)by random number table method.The unilateral locking plate group was treated with unilateral locking plate internal fixation and double-incision double-plate group was treated with double-incision double-plate internal fixation.The perioperative index and postoperative complications of the two groups were recorded.The excellent rate of knee function was evaluated using the Rasmussen knee function score scale.Results The weight-bearing time and fracture healing time of the double-incision double-plate group were shorter than those in the unilateral locking plate group(P<0.05).There was no significant difference between the two groups in terms of operation time,length of incision and intraoperative blood loss(P>0.05).The incidence of postoperative complications in the double-incision double-plate group was lower than that in the unilateral locking plate group(P<0.05).There was no significant difference in the excellent and good rate between the two groups after treatment(P>0.05).Conclusion Both procedures can achieve better results in the treatment of complex tibial plateau fractures.However,double-incision double-plate internal fixation can effectively shorten the fracture healing time and the weight-bearing time of the patients,and the incidence of complications is low.