两种不同内固定方式在复杂性胫骨平台骨折治疗中的临床效果比较

Comparison of clinical effects of two different internal fixation methods in the treatment of complex tibial plateau fractures

目的比较两种不同内固定方式在复杂性胫骨平台骨折治疗中的临床效果。方法选择2014年3月至2017年3月于我院行手术治疗的86例复杂性胫骨平台骨折患者作为研究对象,按照入院时间将其分为观察组(43例,锁定钢板内固定)和对照组(43例,双侧钢板内固定)。比较两组患者的手术相关指标、胫骨平台内翻角(TPA)、后倾角(PA)、膝关节活动度及临床疗效。结果两组的手术时间和住院时间比较,差异均无统计学意义(P>0.05);观察组的骨折愈合时间和完全负重时间均明显短于对照组(P<0.05)。术后6个月,两组的TPA、PA及膝关节活动度比较,差异均无统计学意义(P>0.05)。术后12个月,观察组的关节功能优良率为95.35%,略高于对照组的86.05%,但组间比较,差异无统计学意义(P>0.05)。结论锁定钢板内固定较双侧钢板内固定可进一步缩短患者骨折愈合和完全负重时间,对提高患者的生活质量具有积极意义。

Objective To compare clinical effects of two different internal fixation methods in the treatment of complex tibial plateau fractures.Methods From March 2014 to March 2017,86 patients with complex tibial plateau fractures who were operated in our hospital were selected as the study objects and divided into observation group(43 cases,locked plate internal fixation)and control group(43 cases,bilateral plate internal fixation)according to the admission time.The operative indexes,tibial plateau angle(TPA),posterior slope angle(PA),knee joint mobility and clinical effect of the two groups were compared.Results There were no significant differences in operation time and hospitalization time between the two groups(P>0.05);the time of fracture healing and complete weight-bearing in the observation group were significantly shorter than those in the control group(P<0.05).At 6 months after operation,there were no significant differences in TPA,PA and knee joint activity between the two groups(P>0.05).At 12 months after operation,the excellent and good rate of joint function in the observation group was 95.35%,which was slightly higher than 86.05%in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion Compared with bilateral plate internal fixation,locking plate internal fixation can further shorten the time of fracture healing and complete weight-bearing,which is of positive significance to improve the quality of life of patients.