锁定加压钢板内固定治疗四肢骨折的临床应用价值研究

Study on the clinical application value of locking compression plate internal fixation in the treatment of limb fractures

目的探讨锁定加压钢板内固定治疗四肢骨折的临床应用价值。方法选取120例四肢骨折患者为研究对象,随机分为锁压板固组和非锁压组,各60例。非锁压组实施常规加压钢板内固定治疗,锁压板固组实施锁定加压钢板内固定治疗。对比两组患者手术指标(手术时间、术中出血量、术后骨折愈合时间及术后疼痛情况)、疗效、手术前后肢体功能及并发症发生率。结果锁压板固组手术时间、术后骨折愈合时间分别为(55.73±11.13)min、(135.03±7.63)d,均明显短于非锁压组的(67.13±10.12)min、(143.25±8.36)d,术中出血量(53.66±8.37)ml少于非锁压组的(78.23±11.13)ml,术后24 h、72 h、5 d、7 d和3个月视觉模拟评分法(VAS)评分分别为(4.26±1.13)、(4.83±1.36)、(3.86±1.63)、(2.58±1.16)、(0.93±0.36)分,均显著低于非锁压组的(5.69±1.20)、(5.89±1.23)、(4.96±1.72)、(3.51±1.63)、(1.42±0.39)分,差异有统计学意义(P<0.05)。锁压板固组总有效率98.33%(59/60)显著高于非锁压组的83.33%(50/60),差异有统计学意义(P<0.05)。术前,两组患者上肢功能、下肢功能评分和总分对比,差异无统计学意义(P>0.05)。术后3个月,锁压板固组上肢功能、下肢功能评分和总分分别为(55.38±3.25)、(30.24±3.74)、(85.62±8.27)分,均显著高于非锁压组的(50.69±5.37)、(28.56±5.32)、(79.25±7.25)分,差异有统计学意义(P<0.05)。锁压板固组并发症发生率3.33%(2/60)显著低于非锁压组的16.67%(10/60),差异有统计学意义(P<0.05)。结论四肢骨折患者采用锁定加压钢板内固定治疗的固定效果可靠,疼痛程度较轻,且手术出血量少,并发症发生风险较低,患者康复进程加快,进一步提升患肢功能恢复效果,治疗效果可靠,值得推广应用。

Objective To discuss the clinical application value of locking compression plate internal fixation in the treatment of limb fractures.Methods A total of 120 patients with limb fractures were randomly divided into locking group and non-locking group,with 60 cases in each group.The non-locking group was treated with conventional compression plate internal fixation,and the locking group was treated with locking compression plate internal fixation.The surgical indexes(operative time,intraoperative blood loss,postoperative fracture healing time and postoperative pain),efficacy,limb function before and after surgery and incidence of complications were compared between the two groups.Results The operative time of(55.73±11.13)min and postoperative fracture healing time of(135.03±7.63)d in locking group were significantly shorter than those of(67.13±10.12)min and(143.25±8.36)d in non-locking group;the intraoperative blood loss of(53.66±8.37)ml in locking group was less than that of(78.23±11.13)ml in non-locking group;the differences were statistically significant(P<0.05).At 24 h,72 h,5 d,7 d and 3 months after surgery,VAS scores were(4.26±1.13),(4.83±1.36),(3.86±1.63),(2.58±1.16)and(0.93±0.36)points in locking group,which were significantly lower than those of(5.69±1.20),(5.89±1.23),(4.96±1.72),(3.51±1.63)and(1.42±0.39)points in non-locking group,and the differences were statistically significant(P<0.05).The total effective rate of locking group was 98.33%(59/60),which was significantly higher than that of 83.33%(50/60)of non-locking group,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in the upper limb function score,lower limb function score and total score between the two groups(P>0.05).At 3 months after surgery,the upper limb function score,lower limb function score and total score of locking group were(55.38±3.25),(30.24±3.74)and(85.62±8.27)points,which were significantly higher than those of(50.69±5.37),(28.56±5.32)and(79.25±7.25)points of non-locking group,and the differences were statistically significant(P<0.05).The incidence of complications in the locking group was 3.33%(2/60),which was significantly lower than that of 16.67%(10/60)in non-locking group,and the difference was statistically significant(P<0.05).Conclusion For patients with limb fractures,locking compression plate internal fixation has reliable fixation effect,less pain,less surgical blood loss,lower risk of complications,faster rehabilitation of patients,and can further improve the functional recovery effect of the affected limbs.It has reliable therapeutic effect,and is worthy of promotion and application.