改良双钢板内固定治疗复杂胫骨平台骨折的效果探讨

Discussion on the effect of modified double-plate internal fixation in the treatment of complex tibial plateau fractures

目的 评价改良双钢板内固定治疗复杂胫骨平台骨折的临床效果。方法 128例复杂胫骨平台骨折患者,以随机综合平衡法分为实验组和参照组,各64例。参照组采取锁定钢板内固定治疗,实验组采取改良双钢板内固定治疗。比较两组围手术期指标、并发症发生情况、膝关节功能恢复情况及治疗前后胫骨平台内翻角(TPA)、胫骨平台内翻角后倾角(PA)。结果 实验组手术时间为(106.65±8.72)min,参照组为(113.47±8.91)min;实验组术中失血量为(235.65±10.45)ml,参照组为(247.47±10.82)ml;实验组术后开始负重时间(45.65±5.62)d,参照组为(48.47±5.51)d;实验组住院时间为(15.56±2.53)d,参照组为(17.07±2.31)d;实验组骨折愈合时间为(130.61±7.86)d,参照组为(141.42±7.69)d。实验组手术时间、术后开始负重时间、住院时间、骨折愈合时间均短于参照组,术中失血量少于参照组,差异有统计学意义(P<0.05)。治疗前及治疗后,两组TPA、PA比较,差异无统计学意义(P>0.05)。实验组并发症发生率3.13%低于参照组的12.50%,差异有统计学意义(P<0.05)。实验组膝关节功能恢复优良率95.31%明显高于参照组的84.38%,差异有统计学意义(P<0.05)。结论 复杂胫骨平台骨折采用改良双钢板内固定治疗的效果较为理想,可显著减少出血量,缩短住院时间,有利于术后关节功能恢复,具有临床应用价值。

Objective To evaluate the clinical effect of modified double-plate internal fixation in the treatment of complex tibial plateau fractures.Methods A total of 128 patients with complex tibial plateau fractures were randomly divided into experimental group and reference group by random comprehensive balance method,with 64 cases in each group.The reference group was treated with locking plate internal fixation,and the experimental group was treated with modified double-plate internal fixation.The perioperative indicators,occurrence of complications,knee joint function recovery,tibial plateau angle(TPA)and posterior slope angle(PA)before and after treatment were compared between the two groups.Results In the experimental group,the operation time,intraoperative blood loss,postoperative weight-bearing time,hospitalization time,and fracture healing time were(106.65±8.72)min,(235.65±10.45)ml,(45.65±5.62)d,(15.56±2.53)d,and(130.61±7.86)d;in the reference group,the operation time,intraoperative blood loss,postoperative weight-bearing time,hospital stay,fracture healing time were(113.47±8.91)min,(247.47±10.82)ml,(48.47±5.51)d,(17.07±2.31)d,and(141.42±7.69)d.The operation time,postoperative weight-bearing time,hospitalization time,and fracture healing time of the experimental group were shorter than those of the reference group;the intraoperative blood loss of the experimental group was less than that of the reference group;the differences were all statistically significant(P<0.05).Before and after treatment,there was no statistically significant difference in TPA and PA between the two groups(P>0.05).The incidence of complications 3.13%in the experimental group was lower than 12.50%in the reference group,and the difference was statistically significant(P<0.05).The excellent-good rate of knee joint function recovery in the experimental group was 95.31%,which was significantly higher than 84.38%in the reference group,and the difference was statistically significant(P<0.05).Conclusion Modified double-plate internal fixation has ideal effect in the treatment of complex tibial plateau fractures,which can significantly reduce blood loss,shorten the hospital stay and facilitate postoperative joint function recovery,and has clinical application value.