双反牵引架辅助微创治疗难治性胫骨平台骨折临床价值研究

Clinical value of double reverse traction frame assisted minimally invasive treatment of refractory tibial plateau fracture

目的:探讨双反牵引架辅助微创治疗难治性胫骨平台骨折(TPF)的临床疗效。方法:纳入63例SchatzkerⅤ型和Ⅵ型TPF患者,根据手术方式不同分为对照组(30例)和观察组(33例)。对照组采用传统切开手术,观察组采用双反牵引架辅助微创手术。比较两组手术时间、术中出血量、术后恢复情况、术后膝关节屈伸功能情况、手术切口并发症发生情况。结果:观察组手术时间、术中出血量均低于对照组(P<0.05);观察组术后双下肢长度差、骨折成角均小于对照组(P<0.05);观察组术后负重时间、骨折愈合时间均较对照组短(P<0.05);术后1周、3个月、6个月膝关节屈伸功能活动度均大于对照组(P<0.05);观察组术后切口并发症发生率低于对照组(P<0.05)。结论:双反牵引架辅助微创治疗难治性TPF效果好,可有效改善膝关节屈伸功能,减少手术时间及术中出血量,缩短骨折愈合时间,且术后不良切口并发症少。

Objective:To explore the clinical effect of double reverse traction frame assisted minimally invasive treatment of refractory tibial plateau fracture(TPF).Methods:63 patients with Schatzker typeⅤand typeⅥTPF were included and divided into control group(30 cases)and observation group(33 cases).The control group was treated with traditional operation,and the observation group was treated with double reverse traction frame assisted minimally invasive surgery.The operation time,intraoperative hemorrhage volume,postoperative recovery,flexion and extension function of knee joint and complications of incision were compared between the two groups.Results:The operation time and intraoperative hemorrhage volume in the observation group were lower than those in the control group(P<0.05).The length difference of lower limbs and angle of fracture in the observation group were lower than those in the control group(P<0.05).The weight-bearing time and fracture healing time after surgery in the observation group were shorter than those in the control group(P<0.05).The flexion and extension function activity of knee joint 1 week,3 months and 6 months after surgery in the observation group were higher than that in the control group(P<0.05).The incidence of postoperative incision complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Double reverse traction frame assisted minimally invasive treatment of refractory TPF has good effect,can effectively improve the knee joint flexion and extension function,reduce the operation time and intraoperative hemorrhage volume,shorten the time of fracture healing,and has less postoperative adverse incision complications.