Comparison of Clinical Effect of PFNA and Internal Fixation with Anatomical Locking Plate of Proximal Femur in Treatment of Intertrochanteric Fracture of Femur

Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.

Application of proximal femur locking compression plate for unstable four part intertrochanteric fractures

Objective To evaluate the clinical results of proximal femur locking compression plate (LCP) for unstable four-part intertrochanteric femoral fractures.Methods Clinical data of53patients wiith unstable four-part intertrochanteric

Comparison of Clinical Effect of PFNA and Internal Fixation with Anatomical Locking Plate of Proximal Femur in Treatment of Intertrochanteric Fracture of Femur

Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.

Effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures

Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.

Supracutaneous Locking Compression Plate for Grade I &II Compound Fracture Distal Tibia—A Case Series

Background: Supracutaneous plating using a locking compression plate (LCP) as an external fixator in compound periarticular areas is facilitated by the development of anatomical plates. The soft tissue around the distal tibia is easily compromised by trauma and subsequent operative fracture treatment posing a definitive challenge in the distal tibia compound fractures. The purpose of this report is to describe our successful results using the metaphyseal locking compression plate (LCP) as an external fixator in the treatment of Grade I & II compound fractures of distal tibia. Methodology: A total of five (05) patients underwent “supracutaneous plating” of the tibia using a metaphyseal locking compression plate. Average age was 36 years. Regular screw tract dressings were done. Average period of follow-up was 15 months. Results: The plate was in situ for an average of 24 weeks. There were no clinically significant screw site infections. In all five patients the plate was kept in place until there was complete consolidation both clinically and radiologically. At the latest follow-up (average 15 months), all patients were fully weight bearing with a fully healed tibia. All patients were infection-free with well-healed wounds. Conclusion: Routinely, after initial debridement and temporary bony stabilization is provided by external fixation in compound fractures of the distal tibia with significant soft tissue injury. Most external frames for the lower leg are bulky and cumbersome, causing significant problems for the patient. To circumvent these issues, we have successfully used an anatomically-contoured supracutaneous metaphyseal locking compression plate as external fixator in a series of five patients for grade I & II compound fracture of the distal tibia.

Is Distal Femur Locking Plate a Superior Implant in Distal Femur Fracture?

In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.

Effect of Locking Compression Plate on the Treatment of Limb Fracture and the Effect of Operative Success Rate and Postoperative Recovery Time

Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly divided into control group(60 cases)and observation group(60 cases).The control group was treated with plate screw internal fixation,The observation group used locking compression plate internal fixation,Compare the effect of treatment,the success rate of operation and the time of postoperative recovery.results:compared the effective rate of the two groups,the observation group(93.33%)was significantly higher than the control group(75.00%).Compared with the two groups,the success rate of operation and the time of postoperative recovery,the observed composition power was higher than that of the control group,and the postoperative recovery time was lower than that of the control group,P<0.05.Conclusion:The use of locking compression plate for the treatment of limb fracture can significantly increase the probability of successful operation,shorten the recovery time after operation,the overall curative effect is ideal,and the clinical popularization value is high.

Postoperative Fracture Healing Effects of Locking Compression Plate for the Treatment of Limb Fractures

Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected.In order to study the effective treatment method,the random-number table method was used in this study to divide the patients into two groups,namely the experimental group and the control group,and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects.Results:Compared with the control group,patients in the experimental group had a lower incidence of complications,shorter hospitalizations and shorter recovery time.Meanwhile,the experimental group had a better quality of recovery,and all data were significantly different from those of the control group,P<0.05,the intervention effect of the experimental group was better.Conclusion:The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients'fractures,reducing the incidence of postoperative complications,and promoting the rapid recovery of patients,which has positive significance for clinical development.

两种内固定术式治疗高龄无移位型股骨颈骨折的疗效

目的比较股骨近端锁定接骨板与空心螺钉内固定治疗高龄无移位型股骨颈骨折的疗效。方法根据内固定不同将66例高龄无移位型股骨颈骨折患者分为接骨板组(32例,采用股骨近端锁定接骨板内固定治疗)和螺钉组(34例,采用空心螺钉内固定治疗)。记录两组手术情况、骨折愈合时间、髋关节Harris评分、术后并发症发生情况。结果患者均获得随访,时间6~95个月。手术时间、切口长度、术中出血量、术后血红蛋白下降量两组比较差异均无统计学意义(P>0.05),下床部分负重锻炼时间接骨板组早于螺钉组(P<0.05)。接骨板组骨折均顺利愈合,时间3.5~8.0(4.63±1.04)个月;螺钉组中出现1例骨折不愈合,其余33例骨折愈合时间为3.0~7.5(5.03±1.04)个月;骨折愈合时间两组比较差异无统计学意义(P>0.05)。术后6个月髋关节Harris评分两组比较差异无统计学意义(P>0.05);但髋关节Harris评分优良率接骨板组高于螺钉组(P<0.05)。术后早期并发症发生率两组比较差异无统计学意义(P>0.05),中远期并发症发生率螺钉组高于接骨板组(P<0.05)。结论股骨近端锁定接骨板与空心螺钉内固定治疗高龄无移位型股骨颈骨折均可获得满意疗效,与空心螺钉相比,股骨近端锁定接骨板治疗早期髋关节功能恢复更好,中远期并发症更少。

手术治疗复杂性桡骨远端骨折的效果观察

目的:探讨手术治疗复杂性桡骨远端骨折(DRF)的效果。方法:选择2019年1月—2023年1月苏州市相城人民医院收治的复杂性DRF患者80例作为研究对象,双色球法分为对照组和观察组,对照组给予外固定架治疗,观察组给予锁定加压钢板固定术治疗。比较两组临床疗效、影像学结果、并发症发生情况。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组影像学结果比较,差异无统计学意义(P>0.05);治疗4周后,观察组桡骨短缩短于对照组,尺偏角、掌倾角大于对照组,差异有统计学意义(P<0.05)。治疗前,两组腕关节功能比较,差异无统计学意义(P>0.05);治疗4周后,观察组腕关节功能优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:复杂性DRF患者采取锁定加压钢板固定术治疗,与外固定架治疗比较,有助于提升疗效,更好地改善影像学结果与腕关节功能,还可减少并发症发生,疗效与安全性更好。

股骨近端防旋髓内钉与锁定加压钢板治疗老年合并膝骨关节炎股骨转子间骨折的疗效比较

目的:比较股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)与锁定加压钢板(proximal femoral locking compression plate,PFLCP)治疗老年合并膝骨关节炎股骨转子间骨折的临床疗效。方法:对2015年6月至2021年2月收治的65例老年合并膝骨关节炎股骨转子间骨折患者的临床资料进行回顾性分析,依据手术方法不同分为两组:PFNA组36例,男12例,女24例;年龄61~88(77.0±6.4)岁;左侧17例,右侧19例;改良Evans分型,Ⅱ型3例,Ⅲ型19例,Ⅳ型10例,Ⅴ型4例。PFLCP组29例,男11例,女18例;年龄60~92(78.8±6.5)岁;左侧14例,右侧15例;改良Evans分型,Ⅱ型2例,Ⅲ型18例,Ⅳ型7例,Ⅴ型2例。观察比较两组患者的手术时间、术中出血量、术后卧床时间、术后并发症发生率、骨折愈合时间及术后6个月和1年髋关节Harris评分。结果:65例患者全部获得随访,时间12~24(16.9±3.6)个月。PFNA组和PFLCP组患者手术时间分别为(57.6±6.8)、(77.4±6.5)min;术中出血量分别为(128.3±50.3)、(156.3±22.9)ml;术后卧床时间分别为(4.0±2.5)、(8.1±2.0)d;术后半年髋关节Harris评分分别为(45.3±8.6)、(36.3±7.0)分;两组比较,差异均有统计学意义(P<0.05)。术后并发症发生率分别为19.4%(7/36)、34.5%(10/29),术后1年髋关节Harris评分分别为(60.8±6.7)、(59.0±8.1)分;两组比较,差异均无统计学意义(P>0.05)。结论:与PFLCP相比,PFNA治疗老年合并膝骨关节炎股骨转子间骨折手术时间短,术中出血少,术后卧床时间短、短期髋关节功能恢复更好,在患肢膝关节可耐受牵引时,可作为优先选择。

肱骨近端锁定内固定系统钢板治疗肱骨近端骨折肱骨头螺钉的分布特点

背景:肱骨近端锁定内固定系统钢板是肱骨近端骨折最常用的固定方式,但临床上其失败率仍较高,螺钉的合理置入是影响内固定稳定性的重要因素。目的:探讨在肱骨近端锁定内固定系统钢板治疗肱骨近端骨折中肱骨头螺钉的分布特点及对内固定失效的影响。方法:对2017年1月至2021年12月在广州中医药大学第三附属医院收治的采用肱骨近端锁定内固定系统钢板内固定治疗的老年肱骨近端骨折患者进行回顾性分析,共纳入124例,其中男16例,女108例,年龄≥60岁,根据其术后是否出现内固定失效分为正常组(101例)和内固定失效组(23例)。收集患者年龄、性别、骨折类型、内侧柱完整性、钢板高度、颈干角、是否置入肱骨距螺钉、肱骨头螺钉数量,并根据术后数字X射线摄影正位片将肱骨头分为8个区,收集患者肱骨头螺钉在各区螺钉分布特点,绘制螺钉分布热力图。结果与结论:①两组患者在年龄、性别、骨折类型、内侧柱完整性、钢板高度、颈干角、是否置入肱骨距螺钉、肱骨头螺钉数量方面均无统计学差异(P>0.05);②但热力图显示,在正常组中肱骨头螺钉分布均匀,主要分散在4,6,7区;而内固定失效组的螺钉分布不均匀,主要集中在4,6区;此外,在肱骨距螺钉理想区域(7/8区)中,正常组螺钉明显多于内固定失效组;③提示在肱骨近端锁定内固定系统钢板治疗肱骨近端骨折过程中,肱骨头螺钉均匀分布是保证内固定效果的关键,合理的肱骨头螺钉分布有助于提高治疗效果和内固定成功率。

带锁髓内钉与锁定钢板内固定术治疗肱骨近端Neer二部分骨折患者的效果比较

目的:比较带锁髓内钉与锁定钢板内固定术治疗肱骨近端Neer二部分骨折患者的效果。方法:选取2021年2月至2022年2月该院收治的64例肱骨近端Neer二部分骨折患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各32例。对照组采用锁定钢板内固定术治疗,观察组采用带锁髓内钉内固定术治疗,比较两组手术时间、术中出血量、住院时间、骨性愈合时间、ConstantMurley肩关节功能评分量表(CMS)评分、健康调查简表(SF-36)评分和并发症发生率。结果:观察组术中出血量少于对照组,住院时间和骨性愈合时间短于对照组,差异均有统计学意义(P<0.05);术后6个月,两组SF-36各维度评分高于术前,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为3.12%,明显低于对照组的25.00%,差异有统计学意义(P<0.05);两组手术时间和手术前后CMS评分比较,差异无统计学意义(P>0.05)。结论:带锁髓内钉内固定术治疗肱骨近端Neer二部分骨折患者可提高术后SF-36评分,缩短住院时间和骨性愈合时间,以及降低术中出血量和并发症发生率,效果优于锁定钢板内固定术治疗。

纤维带与无头加压螺钉治疗第1,2跖骨近端粉碎性骨折Lisfranc损伤

背景:Lisfranc韧带是维持足部横弓与纵弓的重要结构,Lisfranc损伤为一种严重的中足损伤。Lisfranc韧带损伤是复杂的,其治疗以及首选的固定方法有争议。目的:比较钢板联合Suturetape与钢板联合无头加压螺钉治疗第1,2跖骨近端粉碎性骨折Lisfranc损伤的短期疗效。方法:回顾性分析东莞市中医院骨七科2019年1月至2022年6月因第1,2跖骨近端粉碎性骨折Lisfranc损伤患者48例,其中25例采用钢板联合Suture tape固定(观察组),23例采用钢板联合无头加压螺钉固定(对照组)。术前参照影像学资料,根据Myerson分类系统进行分型;术后随访根据骨折愈合时间、目测类比评分、美国足踝外科学会标准评估足功能恢复情况,并对两组术后并发症进行比较分析。结果与结论:①两组患者均顺利完成手术并获得随访,随访时间12-36个月,平均(18.0±5.42)个月;②两组患者手术时间、术中出血量比较差异均无显著性意义(P>0.05);③观察组较对照组骨折愈合时间稍长,差异有显著性意义(P<0.05);④术后3,6,12个月随访,观察组较对照组目测类比评分明显降低(P<0.05);⑤术后6,12个月,观察组术后各时间点随访足功能AOFAS评分较螺钉组明显改善(P<0.05),且均较术前显著提高(P<0.05);⑥术后观察组出现1例创伤性关节炎,对照组出现1例切口感染、1例螺钉断裂及2例创伤性关节炎,两组比较差异无显著性意义(P>0.05),考虑与样本量偏少有关;⑦提示对于第1,2跖骨近端粉碎性骨折Lisfranc损伤,实施钢板联合Suture tape内固定治疗Lisfranc关节损伤效果可靠,可改善患者足关节功能,且具有手术创伤小、术后并发症少、远期医源性创伤性关节炎风险低的优势,较无头加压钉更有利于足功能的恢复。

桥接组合式内固定和锁定加压钢板治疗股骨干粉碎性骨折的疗效比较

目的 比较桥接组合式内固定系统和锁定加压钢板治疗股骨干粉碎性骨折的疗效。方法 2017年1月~2021年6月收治的股骨干粉碎性骨折病人97例,其中42例实施锁定加压钢板内固定手术(钢板组),55例实施桥接组合式内固定手术(桥接组),随访至少12个月。比较两组的围手术期资料、随访资料和并发症情况。结果 钢板组和桥接组的手术时间分别为(95.37±19.31)分钟和(77.83±15.32)分钟,术中出血分别为(425.37±47.56)ml和(398.72±43.29)ml,术后引流量分别为(123.42±19.87)ml和(106.39±14.20)ml,住院时间分别为(19.31±4.26)天和(16.2 4±3.79)天,两组比较差异有统计学意义(P<0.05);术后随访1年,桥接组和钢板组的髋关节ROM分别为(132.31±15.47)°和(125.35±17.11)°、膝关节活动度ROM分别为(139.68±16.69)°和(131.49±18.24)°,两组比较差异有统计学意义(P<0.05),骨折愈合时间分别为(5.42±0.87)个月和(6.28±1.07)个月,Harris评分分别为(83.49±9.31)分和(77.57±6.39)分,HSS评分分别为(85.35±6.90)分和(80.32±7.79)分,两组比较差异有统计学意义(P<0.05)。两组切口长度和并发症比较,差异无统计学意义。结论 相比于锁定加压钢板,桥接组合式内固定治疗股骨干粉碎性骨折的手术创伤更小,骨折愈合更快,术后功能更好。

两种复位方式锁定加压钢板内固定治疗老年股骨远端骨折的疗效比较

目的 比较切开复位和闭合复位锁定加压钢板内固定治疗老年股骨远端骨折的疗效。方法 将72例老年股骨远端骨折患者按照复位方式不同分为切开复位组(采用切开复位锁定加压钢板内固定治疗,31例)和闭合复位组(采用闭合复位锁定加压钢板内固定治疗,41例)。比较两组围手术期指标、骨折愈合时间、术后并发症发生情况。采用HSS评分评价膝关节功能。结果 患者均获得随访,时间12~48个月。骨折复位时间、术中出血量、手术时间、骨折愈合时间闭合复位组均短(少)于切开复位组(P<0.01);术中透视次数闭合复位组多于切开复位组(P<0.01)。术后输血率、术后并发症发生率闭合复位组均低于切开复位组(P<0.01)。HSS评分优良率:术后3个月闭合复位组高于切开复位组(P<0.01);术后12个月两组比较差异无统计学意义(P>0.05)。结论 与切开复位相比,闭合复位锁定加压钢板内固定治疗老年股骨远端骨折,操作简单,具有手术时间短、骨折复位时间短、术中出血量少、术后并发症少的优势,更利于骨折愈合及早期膝关节功能的恢复。

PFNA、PFALP治疗老年人股骨转子间骨折的临床疗效及对并发症发生率的影响分析

目的比较防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)、股骨近端解剖锁定钢板(proximal femoral anatomic locking plate,PFALP)治疗老年人股骨转子间骨折的临床疗效及对并发症发生率的影响。方法回顾性选取2020年2月—2023年2月京山市人民医院收治的180例老年股骨转子间骨折患者的临床资料,以治疗方式差异分为研究组(行PFNA治疗)和对照组(行PFALP治疗),各90例。对比两组骨折恢复优良率、临床指标、疼痛评分及并发症情况。结果研究组的骨折恢复优良率为88.89%,明显高于对照组的77.78%,差异有统计学意义(χ^(2)=4.000,P<0.05)。研究组的临床指标、视觉模拟评分法评分及并发症总发生率明显低于对照组,差异有统计学意义(P均<0.05)。结论相比PFALP,PFNA治疗老年股骨转子间骨折的效果更好,安全性更高,可促进患者早日康复。

髓内钉与肱骨近端锁定钢板治疗肱骨近端骨折疗效比较

目的比较髓内钉与肱骨近端锁定钢板治疗肱骨近端骨折的疗效差异。方法回顾性分析2021年5月至2023年5月开封市第二中医院收治的86例肱骨近端骨折患者的临床资料,其中采用髓内钉治疗的43例为观察组,采用肱骨近端锁定钢板内固定治疗的43例为对照组。评估手术相关指标及术后恢复情况,观察手术前后血清丙二醛(MDA)、超氧化物歧化酶(SOD)、骨碱性磷酸酶(BALP)水平,比较两组患者肩关节功能、Constant-Murley评分、视觉模拟量表(VAS)评分以及术后并发症发生率。结果观察组手术时间[(86.13±10.68)min]、切口长度[(5.29±2.28)cm]、住院天数[(7.36±2.89)d]均短于对照组[(93.50±10.62)min、(7.40±2.22)cm、(10.51±2.80)d],术中出血量[(131.52±10.53)mL]少于对照组[(156.45±10.45)mL];术后2 d观察组MDA[(2.53±0.14)μmol/L]水平低于对照组[(2.89±0.21)μmol/L],SOD[(163.11±15.60)KU/L]、BALP[(78.65±5.48)U/L]水平高于对照组[(151.03±15.41)KU/L、(70.31±5.51)U/L];术后1个月肩关节被动前屈[(129.43±15.51)°]、外展[(137.13±13.33)°]、外旋活动度[(35.08±5.20)°]及术后3个月Constant-Murley评分[(71.15±5.86)分]均高于对照组[(121.76±15.48)°、(130.42±13.21)°、(30.12±5.11)°、(66.12±5.77)分];术后并发症总发生率(4.65%)低于对照组(30.23%)。上述指标两组比较,差异均有统计学意义(P<0.05)。结论与肱骨近端锁定钢板比较,髓内钉治疗肱骨近端骨折具有缩短手术时间、减少术中出血量、减轻氧化应激反应、改善肩关节功能、降低术后并发症发生率的优势。

锁定加压钢板内固定术治疗四肢骨折的临床效果分析

目的:分析锁定加压钢板内固定术治疗四肢骨折的临床效果。方法:选取2018年4月—2023年4月于新疆生产建设兵团第九师医院接受诊疗的70例四肢骨折患者作为观察对象,以随机数字表法分为两组,每组35例。对照组实施常规钢板固定术治疗,观察组实施锁定加压钢板内固定术治疗。比较两组临床疗效。结果:相较于对照组,观察组骨折愈合总优良率更高(P<0.05)。观察组手术时间、骨痂形成时间、骨折愈合时间、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率为5.71%,低于对照组(17.14%),差异有统计学意义(P=0.011)。结论:锁定加压钢板内固定术治疗四肢骨折的临床效果显著,可促进患者康复,缩短住院时间,且术后并发症少。

微创经皮锁定加压钢板内固定术与切开复位内固定术治疗胫骨平台骨折患者的效果比较

目的:比较微创经皮锁定加压钢板内固定术与切开复位内固定术治疗胫骨平台骨折患者的效果。方法:选取2020年1月至2023年1月该院收治的86例胫骨平台骨折患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各43例。对照组采用切开复位内固定术治疗,研究组采用微创经皮锁定加压钢板内固定术治疗,比较两组临床疗效、围术期指标水平、术后膝关节功能[Lysholm膝关节功能量表(LKS)]评分、手术前后创伤应激指标[肾上腺素(E)、β-内啡肽(β-EP)、皮质醇(Cor)]水平、术后并发症发生率。结果:研究组治疗优良率为95.35%(41/43),高于对照组的79.07%(34/43),差异有统计学意义(P<0.05);研究组切口长度、骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);研究组LKS评分、膝关节最大伸膝、屈膝角度均高于对照组,差异有统计学意义(P<0.05);术后7 d,两组E、β-EP、Cor水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:微创经皮锁定加压钢板内固定术治疗胫骨平台骨折患者可提高治疗优良率和膝关节功能恢复指标水平,降低应激反应指标水平和并发症发生率,其效果优于切开复位内固定术治疗。