锁定钢板内固定治疗复杂胫骨平台骨折的疗效观察

目的:探讨锁定钢板内固定治疗复杂胫骨平台骨折的临床疗效。方法:选择2011年2月~2013年2月期间我院收治的复杂胫骨平台骨折92例,按照数字随机法分为观察组(50例)和对照组(42例)。观察组采用锁定钢板内固定治疗;对照组采用传统钢板固定治疗,所有患者术后随访1年以上,观察两组患者临床疗效。结果:①两组患者均顺利完成手术,观察组住院时间、骨折愈合时间和完全负重时间显著低于对照组(P0.05)。②治疗后两组患者胫骨平台后倾角(Posterior tibial angle,PA)、膝关节活动度逐渐升高,内翻角(Tibial plateau angle,TPA)逐渐降低(P0.05),治疗6、12个月观察组PA、膝关节活动度显著高于对照组,TPA显著低于对照组(P0.05)。③所有患者术后随访1年,均获得满意随访。观察组膝总有效率为86.0%;对照组总有效率为66.7%,观察组膝关节总有效率显著高于对照组(P0.05)。结论:锁定钢板内固定治疗复杂胫骨平台骨折具有固定牢靠,骨折愈合时间短,愈合率高等特点,其临床效果较好。

Clinical Observation on Efficacy of Locking Plate Fixation for the Treatment of Eomplex Tibial Plateau Fractures

Objective:To investigate the clinical efficacy of locking plate fixation for the treatment of complex tibial plateau fractures.Methods:92 cases of complex tibial plateau fractures in our hospital from February 2011 to February 2013 were selected and randomly divided into observation group (50 cases) and control group (42 cases). The observation group was treated with locking plate internal fixation; the control group used the traditional plate fixation, all patients were followed up for more than 1 year.Results:The operation of the patients in 2 groups were all successfully completed ,the hospitalization time, fracture healing time and full weight-bearing time of the observation group were significantly lower than those of the control group (P<0.05). After the treatment,the PA and knee joint activity both gradually increased in the two groups, while the TPA decreased gradually (P<0.05). After 6, 12 months of treatment, PA and the knee joint activity of the observation group are significantly higher than those of control group, while TPA was significantly lower than that of the control group (P<0.05). All patients were followed up for 1 year, which presented satisfactory. The knee joint total efficiency of the observation group was 86% and 66.7% for the control group, between which was a statistically significant difference(P<0. 05).Conclusion:In the treatment of complex tibial plateau fractures, the locking plate fixation presents shorter fracture healing time, higher healing rate and better clinical effect.