双钢板与双钢板联合加压螺钉治疗双髁胫骨平台骨折的效果对比

Comparison of the effect of double plate and double plate combined with c ompression screw in treatment of bicondylar tibial plateau fracture

目的:比较用单纯双钢板内固定术与双钢板联合加压螺钉内固定术治疗双髁胫骨平台骨折的临床效果。方法:选取2015年1月至2020年8月于广州市花都区第二人民医院行双钢板内固定术的双髁胫骨平台骨折患者72例,根据手术方式的不同将其分为1组和2组。为1组患者采用单纯双钢板内固定术进行治疗,为2组患者采用双钢板联合加压螺钉内固定术进行治疗。然后观察两组患者的术前术后随访影像学资料、手术记录信息、骨折愈合时间、术后并发症的发生情况、术后骨折复位质量和术后膝关节功能的恢复情况。结果:在术后,2组患者中出现继发复位丢失情况患者的占比低于1组患者,差异有统计学意义(P<0.05)。在术后,2组患者的HSS评分高于1组患者,差异有统计学意义(P<0.05)。两组患者的手术时间、术中出血量、住院时间、骨折愈合时间、Lysholm评分、术后并发症的发生率相比,差异无统计学意义(P>0.05)。结论:与采用单纯双钢板内固定术相比,用双钢板联合加压螺钉内固定术治疗双髁胫骨平台骨折的效果较好,可有效降低患者的继发复位丢失率,改善其膝关节功能。

Objective:To compare the clinical effect of double plate internal fixation and double plate combined with compression screw internal fixation in the treatment of bicondylar tibial plateau fracture.Methods:A total of 72 patients with bicondylar tibial plateau fracture who received double plate internal fixation in the Second People’s Hospital of Huadu District,Guangzhou from January 2015 to August 2020 were selected and divided into group 1 and group 2 according to different surgical methods.Patients in group 1 were treated with double plate internal fixation alone,and patients in group 2 were treated with double plate combined with compression screw internal fixation.Then,preoperative and postoperative follow-up imaging data,surgical records,fracture healing time,postoperative complications,postoperative fracture reduction quality and postoperative recovery of knee joint function of the two groups were observed.Results:After surgery,the proportion of patients with secondary reduction loss in the 2 groups was lower than that in the 1 group,the difference was statistically significant(P<0.05).After surgery,HSS score of 2 groups was higher than that of 1 group,the difference was statistically significant(P<0.05).There were no significant differences in operative time,intraoperative blood loss,length of hospital stay,fracture healing time,Lysholm score and incidence of postoperative complications between 2 groups(P>0.05).Conclusion:Compared with simple internal fixation with double plate,internal fixation with double plate combined with compression screw has a better effect on the treatment of bicondylar tibial plateau fracture,which can effectively reduce the secondary reduction and loss rate of patients and improve the function of knee joint.