前外侧小切口结合L型锁定钢板治疗胫骨远端骨折的临床疗效

Clinical effect of small anterolateral incision combined with L-shaped locking plate in the treatment of distal tibial fractures

目的探讨前外侧小切口结合L型锁定钢板治疗胫骨远端骨折的临床疗效。方法回顾性分析本院2014年1月至2019年12月收治的82例胫骨远端闭合性骨折患者的临床资料,随机分为对照组与观察组,每组41例。对照组行切开复位内固定术治疗,观察组行前外侧小切口结合L型锁定钢板治疗。比较两组围术期指标、术后12个月踝关节功能(Johner-Wruhs评分)、术后并发症发生率。结果观察组住院时间、手术时间、骨折愈合时间、骨痂生成时间均短于对照组,出血量少于对照组,差异有统计学意义(P<0.05)。术后12个月,观察组Johner-Wruhs评分优良率为92.7%,高于对照组的75.6%,差异有统计学意义(P<0.05)。观察组术后并发症发生率为2.44%,低于对照组的14.63%,差异有统计学意义(P<0.05)。结论前外侧小切口结合L型锁定钢板治疗胫骨远端骨折具有固定可靠、骨折愈合时间短等优点,临床疗效显著。

Objective To explore the clinical effect of small anterolateral incision combined with L-shaped locking plate in the treatment of dis-tal tibial fractures.Methods The clinical data of 82 patients with closed fractures of the distal tibia admitted to our hospital from January 2014 to De-cember 2019 were retrospectively analyzed and they were randomly divided into control group and observation group,with 41 cases in each group.The control group underwent open reduction and internal fixation,and the observation group underwent small anterolateral incision combined with L shaped locking plate for treatment of distal tibial fractures.The perioperative indicators,ankle joint function(Johner-Wruhs score)12 months after operation,and postoperative complication rates between the two groups were compared.Results The duration of hospital stay,operation time,frac-ture healing time and callus formation time in the observation group were shorter than those in the control group,and the amount of blood loss was less than that in the control group,the difference was statistically significant(P<0.05).12 months after operation,the excellent and good rate of Johner Wruhs score in the observation group was 92.7%,which was higher than 75.6%in the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 2.44%,which was lower than 14.63%in the control group,the dif-ference was statistically significant(P<0.05).Conclusion Small anterolateral incision combined with L-type locking plate in the treatment of dis-tal tibial fracture has the advantages of reliable fixation and short fracture healing time,which has significant clinical effect.