摘要
目的探讨锁定接骨板结合空心拉力螺钉对胫骨平台粉碎性骨折近期疗效和远期功能的影响。方法前瞻性选取2012年1月~2014年3月我院收治的胫骨平台粉碎性骨折患者64例,按数字随机法将其分为实验组（n=32）和对照组（n=32）。对照组常规行开放复位、胫骨髓内钉置入辅助普通钢板内固定治疗,实验组采用开放复位、植入空心拉力螺钉辅助锁定接骨板内固定治疗。比较两组手术情况、骨折愈合时间、完全负重时间、术后1个月、6个月和1年膝关节功能Rasmussen评分和HSS评分及并发症发生率。结果实验组和对照组术中出血量和术后住院时间比较,无显著性差异（P〉0.05）;与对照组比较,实验组手术时间、术后骨折愈合时间、完全负重时间均缩短,术后1个月、6个月和1年膝关节功能Rasmussen评分和HSS评分均提高（P〈0.05）;实验组术后骨不连、伤口感染、内固定物松动或损坏、下肢静脉血栓、创伤性关节炎等并发症的发生率为15.63%,低于对照组的46.88%,两组比较,差异有统计学意义（P〈0.05）。结论锁定接骨板结合空心拉力螺钉对胫骨平台粉碎性骨折可促进患者康复,其近期疗效和远期膝关节功能良好且术后并发症发生少,具有良好的可行性和安全性,值得临床推广使用。
Objective To investigate the effect of near curative effect and long-term function of locking plate combined with cannulated lag screws treating tibial plateau fractures. Methods 64 cases with tibial plateau fractures in our hospital from Jan 2012 to Mar 2014 were selected and divided into experimental group(n=32) and control group(n=32) according to the digital random method.Control group had conventional open reduction,tibia intramedullary nail and auxiliary ordinary steel plate internal fixation treatment,and the experimental group had open reduction,implanted cannulated lag screws and auxiliary locking plate internal fixation treatment.Operation situation,fracture healing time,full weight bearing time,postoperative 1 month,6 months and 1 year Rasmussen knee function score and HSS score and the incidence of complications of two groups were compared. Results Intraoperative blood loss and postoperative hospital stay of the experimental group and control group had no significant difference(P>0.05).Compared with control group,operation time,postoperative fracture healing time,complete loaded time of the experimental group were shortened,and the postoperative 1 month,6 months and 1 year Rasmussen knee function score and HSS scores of the trial group were increased(P<0.05).Postoperative bone nonunion,wound infection,internal fixation loosening or damage,lower limb vein thrombosis,traumatic sex arthritis and other the complications incidence of the experimental group was 15.63%,which was less than 46.88% of the control group(P<0.05). Conclusion Locking plate combined with cannulated lag screws treating patients with tibial plateau fractures can promote health recovery,with good short-term efficacy and long-term knee function and less postoperative complications,therefore it has good feasibility and safety and is worthy of clinical use.
出处
《中国现代医药杂志》
2016年第12期31-34,共4页
Modern Medicine Journal of China
