锁定加压钢板治疗四肢骨折73例的临床效果观察

Clinical Observation of 73 Cases of Limb Fracture Treated with Locking Compression Plate

目的:探讨锁定加压钢板治疗四肢骨折的临床应用价值。方法:收治73例四肢骨折患者作为研究对象。采取随机数字表法设置为对照组与观察组,对两组患者均行X射线拍片检查,确定患者骨折部位、严重程度、骨折类型。为牵引、手术治疗等做好定位和指导。对出现肿胀的骨折患者,需及时进行复位牵引,并配用药物进行消肿处理,待患者肿胀消除后,再行手术治疗。对开放性骨折患者,做好窗口防感染处理,术前对患者做好全面检查,确保患者符合手术指征。其中对照组有21例采用单纯钢板螺钉内固定治疗,观察组52例采用锁定加压钢板固定进行治疗,对比两组患者骨折愈合时间、愈合率、并发症及Johner-Wruh功能评分。结果:采用锁定钢板加压的观察组愈合时间优于对照组;其中对照组愈合率为90.48%,观察组愈合率为100%,P<0.05;对两组患者治疗6个月后进行Johner-Wruh评分,其中对照组患者优良率为66.67%,显著低于采用锁定加压钢板内固定治疗的观察组(94.23%),P<0.05;对照组中2例感染,1例脱落,1例肌腱严重损伤,并发症发生率为19.05%;观察组中2例感染,1例固定脱落,无肌腱严重损伤,并发症发生率为5.77%,有统计学意义,P<0.05。结论:患者在采用锁定加压钢板治疗后可以看到患者的手术时间、骨折愈合时间、Johner-Wruh评分与常规加压钢板螺钉内固定治疗相比均得到有效地提升,锁定加压钢板能更好地改善患者的运动功能,安全性更高、创伤小、并发症发生率更低,有效提升患者生存质量。

Objective:To investigate the clinical value of locking compression plate in the treatment of limb fracture.Methods:73 cases of limb fracture were treated as the study object.Randomized numerical table method was used to set up the control group and the observation group.The patients in both groups were examined by X-ray to determine the fracture site,severity and type.Provide good positioning and guidance for traction and surgical treatment.For the fracture patients with swelling,timely reduction and traction should be carried out,and drugs should be used for detumescence treatment.After the swelling of the patients is eliminated,surgery should be carried out.For patients with open fracture,the window shall be properly treated to prevent infection,and the patients shall be comprehensively examined before operation to ensure that the patients meet the surgical indications.Among them,21 cases in the control group were treated with simple plate and screw internal fixation,and 52 cases in the observation group were treated with locking compression plate fixation.The fracture healing time,healing rate,complications and Johner Wruh functional score of the two groups were compared.Results:The healing time of the observation group was better than that of the control group.The healing rate of the control group was 90.48%and that of the observation group was 100%(P<0.05).After 6 months of treatment,Johner-Wruh score was performed in both groups,and the excellent and good rate in the control group was 66.67%,significantly lower than that in the observation group treated with locking compression plate internal fixation(94.23%,P<0.05).In the control group,there were 2 cases of infection,1 case of shedding,1 case of severe tendon injury,and the complication rate was 19.05%.In the observation group,there were 2 cases of infection,1 case of fixation and shedding,no serious tendon injury,and the complication rate was 5.77%.P<0.05 was statistically significant.Conclusion:The operation time,fracture healing time and Johner Wruh score of patients treated with locking compression plate can be effectively improved compared with that of patients treated with conventional compression plate and screw internal fixation.Locking compression plate can better improve patients'exercise function,with higher safety,less trauma,lower complication rate,and effectively improve patients'quality of life.