不同手术方法治疗复杂胫骨平台骨折临床疗效观察

The Clinical Effect of Different Operative Methods in the Treatment of Complex Tibial Plateau Fracture

目的探讨不同手术方法治疗复杂胫骨平台骨折临床疗效。方法选择2016年1月—2018年12月84例复杂胫骨平台骨折患者,随机分组。单侧锁定钢板内固定组选择单侧锁定钢板内固定手术,双侧切口双侧解剖钢板内固定组选择双侧切口双侧解剖钢板内固定。分析手术操作时间、手术失血、平均住院天数以及复杂胫骨平台骨折愈合时间;治疗前后患者视觉模拟评分和Rasmussen膝关节功能评分;膝关节僵硬发生率。结果双侧切口双侧解剖钢板内固定组视觉模拟评分和Rasmussen膝关节功能评分、手术操作时间、手术失血、平均住院天数以及复杂胫骨平台骨折愈合时间、膝关节僵硬发生率和单侧锁定钢板内固定组比较有优势,P<0.05。结论复杂胫骨平台骨折患者实施双侧切口双侧解剖钢板内固定可获得较好效果。

Objective To explore the clinical effect of different surgical methods in the treatment of complex tibial plateau fractures.Methods From January 2016 to December 2018,84 patients with complex tibial plateau fractures were randomly divided into two groups.In the group of unilateral locking plate internal fixation,unilateral locking plate internal fixation was selected,and in the group of bilateral incision and bilateral anatomical plate internal fixation,bilateral incision and bilateral anatomical plate internal fixation was selected.The operation time,blood loss,average hospital stay and healing time of complex tibial plateau fracture were analyzed;the visual simulation score and Rasmussen knee function score of patients before and after treatment and the knee stiffness were compared.Results The visual simulation score,Rasmussen knee joint function score,operation time,blood loss,average hospitalization days,healing time of complex tibial plateau fracture,knee joint stiffness in the group of bilateral incision and bilateral anatomical plate internal fixation were superior compared with unilateral locking plate internal fixation group(P<0.05).Conclusion Internal fixation with anatomic plates of bilateral incisions can achieve better results in patients with complex tibial plateau fractures.