锁定加压钢板内固定治疗胫骨Pilon骨折临床疗效观察

Clinical effect of locking compression plate fixation in the treatment of tibial pilon fractures

目的观察锁定加压钢板内固定治疗胫骨Pilon骨折的临床效果与安全性。方法选取2012年1月至2013年5月我院收治的胫骨Pilon骨折患者62例,采用随机数字表法分为观察组和对照组各31例,对照组采用解剖型钢板内固定治疗,观察组采用锁定加压钢板内固定治疗,观察两组患者的临床疗效、骨折愈合时间、住院接受治疗时间及围手术治疗期间不良反应。结果观察组患者的骨折愈合时间为(8.56±1.25)周,住院治疗时间为(17.15±3.64)d,均明显少于对照组,差异均有统计学意义(P<0.05);观察组患者优、良人数较多,及格率高达93.55%,明显高于对照组的74.19%,差异有统计学意义(P<0.05);治疗前两组患者的Mazur评分差异无统计学意义(P>0.05),治疗后观察组患者的Mazur评分为(87.35±4.75)分,明显高于对照组的(73.27±4.88)分,差异有统计学意义(P<0.05);对照组患者围术期有6例出现不良反应,发生率为19.35%,观察组有2例出现不良反应,发生率为6.45%,差异有统计学意义(P<0.05)。结论锁定加压钢板内固定符合生物学固定原则,治疗胫骨Pilon骨折疗效显著,术后骨折愈合快,并发症发生率低,值得临床推广。

Objective To observe the clinical effect of locking compression plate fixation in the treatment of tibial pilon fractures. Methods Sixty-two patients with tibial pilon fractures in our hospital from January 2012 to May2012 were divided into the study group and control group based on random number table, with 31 patients in each group.The study group applied locking compression plate internal fixation for treatment, while the control group adopted anatomic plate internal fixation. The clinical curative effect, fracture healing time, length of hospital stay, perioperative adverse reactions during the treatment were observed and compared between the two groups. Results The fracture healing time and the length of hospital stay in the observation group were(8.56±1.25) weeks and(17.15±3.64) days, significantly shorter than those in the control group(P<0.05). In the observation group, more patients reached excellent or good results, and the pass rate was 93.55%, significantly higher than 74.19% in the control group(P<0.05). Mazur scores before treatment showed no statistically significant difference between the two groups(P>0.05), but the score in the observation group after treatment [(87.35 ± 4.75)] was significantly higher than [(73.27 ± 4.88)] in the control group(P<0.05).There were 6 patients(19.35%) in the control group and 2 patients(6.45%) in the observation group had perioperative adverse reactions, with statistically significant difference between the two groups(P<0.05). Conclusion Locking compression plate fixation conforms to the principle of biological fixation and has significant therapeutic effect for treating tibial pilon fractures, with fast fracture healing and low incidence of complications, which is worthy of clinical promotion.