双钢板内固定治疗复杂胫骨平台骨折的效果

Effect of double plate internal fixation in the treatment of complex tibial plateau fractures

目的探讨复杂胫骨平台骨折患者接受膝前正中直切口双钢板内固定治疗的临床效果。方法选取2019年1月—2020年1月天津市河西区康复医院收治的64例复杂胫骨平台骨折患者为研究对象,根据患者住院床号的奇偶性分为对照组和观察组各32例。对照组给予单侧锁定钢板内固定治疗,观察组给予膝前正中直切口双钢板内固定治疗。比较两组手术相关指标、膝关节功能、下肢功能评分及生活质量评分。结果观察组术中出血量少于对照组,手术时间、骨折愈合时间以及患肢负重时间短于对照组,差异均有统计学意义(P<0.05)。观察组术后关节优良率为90.63%,高于对照组的68.75%,差异有统计学意义(P<0.05)。术前,两组患者的FAC、Fugl-Meyer、GQOL-74评分比较,差异无统计学意义(P>0.05);术后,观察组的FAC、Fugl-Meyer、GQOL-74评分均高于对照组,差异均有统计学意义(P<0.05)。结论复杂胫骨平台骨折患者接受膝前正中直切口双钢板内固定治疗,可缩短手术时间、减少出血量,有利于骨折早期愈合,促进患者早日康复。

Objective To explore the clinical effect of double plate internal fixation with anterior and median straight incision in the treatment of complex tibial plateau fracture.Methods Sixty four patients with complex tibial plateau fractures admitted to Tianjin Hexi District Rehabilitation Hospital from January2019 to January 2020 were selected as the study objects.According to the parity of bed number,they were divided into control group and observation group with 32 cases in each group.The control group was treated with unilateral locking plate internal fixation,and the observation group was treated with anterior median straight incision double plate internal fixation.The operation related indexes,knee joint function,lower limb function score and quality of life score of the two groups were compared.Results The intraoperative blood loss of the observation group was less than that of the control group,and the operation time,fracture healing time and weight-bearing time of the affected limb of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of joint in the observation group was 90.63%,which was higher than 68.75%in the control group,and the difference was statistically significant(P<0.05).Before operation,there were no significant differences in FAC,Fugl-Meyer and GQOL-74 scores between the two groups(P>0.05);after operation,the FAC,Fugl-Meyer and GQOL-74 scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The treatment of complex tibial plateau fractures with double plate internal fixation through anterior median straight incision could shorten the operation time,reduce the amount of bleeding,which was conducive to early fracture healing and promote the prognosis of patients.