中国学术期刊网络出版总库入编期刊
CNKI中文期刊全文数据库全文收录期刊
中国核心期刊(遴选)数据库全文收录期刊
万方数据——数字化期刊群收录期刊
中文科技期刊数据库全文收录期刊

主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

胫骨平台骨折切开复位内固定术的临床效果观察

孙治国,李延明

(陕西省延安医疗集团总医院延长分院/陕西省延长县人民医院,陕西 延安,717199)

浏览次数:126次 下载次数:309次

摘要:

目的 观察并且分析切开复位内固定术治疗胫骨平台骨折的临床效果。方法 将2012年4月至2015年7月我院收治的100例胫骨平台骨折患者作为研究对象,随机将其分作观察组和对照组,各50例。观察组采取切开复位内固定术,对照组 给予手法复位骨外固定架进行固定,随访6~12 个月,对两组患者的治疗优良率及并发症的发生情况进行对比分析。结果 观察组治疗痊愈32例,显效14例,有效3例,未愈1例,总显效率为92.00%;对照组治疗痊愈18 例,显效18例,有效9例,未 愈5 例,总显效率为72.00%。观察组总显效率明显高于对照组(X2=6.7751,P<0.01)。并发症方面,观察组术后关节不稳1 例,关节僵直1 例,骨折延迟愈合1例;对照组术后关节不稳2 例,关节僵直3 例,骨折延迟愈合2 例,创伤性关节炎2 例,畸形 愈合3 例;观察组并发症明显少于对照组(X2=6.3529,P<0.05)。结论 胫骨平台骨折患者采取切开复位内固定术治疗具有临床 效果显著、并发症少等优点,具有很好的临床应用价值。

关键词:胫骨平台骨折;切开复位内固定术;外固定

中图分类号:R687.3 文献标志码:A文章编号:2096-1413(2016)25-0043-03

    The clinical efficacy observation of incision restoration and internal fixation for tibial plateau fracture
    SUN Zhi-guo, LI Yan-ming
    (Yanchang Branch Hospital, General Hospital of Yan`an Medical Group in Shaanxi Province / Yanchang County People`s Hospital,

    Yan`an 717199, China)

    ABSTRACT: Objective To observe and analyze the clinical effect of incision restoration and internal fixation for tibial plateau fracture. Methods One hundred cases of patients with tibial plateau fracture admitted in our hospital from April 2012 to July 2015 were selected and divided into observation group and control group. The 50 cases of observation group were given open reduction and internal fixation, while the 50 cases of control group were given external skeletal fixation. The excellence rates and complications were evaluated after 6-12 months follow-up. Results In the observation group, 32 cases were cured, 14 cases were excellent, 3 cases were effective, 1 case was ineffective, and the total excellent rate was 92.00%. In control group, 18 cases were cured, 18 cases were excellent, 9 cases were effective, 5 cases were ineffective, and the total excellent rate was 72.00%. The excellent rate in the observation group was significantly higher than that in the control group ( X2=6.7751, P<0.01). In the observation group, there were joint instability for 1 case, joint ankylosis for 1 case and delay fracture healing for 1 case. In the control group, there were joint instability for 2 cases, joint ankylosis for 3 cases, delay fracture healing for 2 cases, traumatic osteoarthritis for 2 cases, and malformed cicatrisation for 3 cases. The incidence rate of complication in the observation group was lower than that in the control group ( X2=6.3529, P<0.05). Conclusion
    Incision restoration and internal fixation have a remarkable clinical effect in the treatment of patients with tibial plateau fracture, with fewer complications.
    KEYWORDS: tibial plateau fracture; incision restoration and internal fixation; external fixation

    参考文献:
    [1] 张会忠.复杂胫骨平台骨折手术治疗的病例对照研究[J].当代医学,2014,21(7):4-6.
    [2] RATHOD AK,DHAKE RP,ADITYA P.Minimally invasive treatment of a complex tibial plateau fracture with diaphyseal extension in a patient with uncontrolled diabetes mellitus: a case report and review of literature[J].Cureus,2016,8(5):e599.
    [3] 王亦璁.骨与关节损伤[M].北京:人民卫生出版社,2003:1030.
    [4] 李成.中西医结合治疗胫骨平台骨折疗效观察[J].陕西中医,2012,33(12):1630-1632.
    [5] 孙可.中西医结合疗法在胫骨平台骨折术后康复治疗中的临床效果观察[J].中华中医药学刊,2015,34(10):2529-2532.
    [6] ELKASSABANY N,CAI LF,MEHTA S,et al.Does regional anesthesia improve the quality of postoperative pain management and the quality of recovery in patients undergoing operative repair of tibia and ankle fractures[J].J Orthop Trauma,2015,29(9):404-409.
    [7] BENTIVEGNA E,CITARRELLA E,VIVALDI R,et al.Leg ulcer and osteomyelitis due to methicillin -susceptible staphylococcus aureus infection after fracture repair treatment: a case highlighting the potential role of prostaglandin E1 vasodilator[J].Infez Med,2015,23(1):69-73.
    [8] 桑大伟.切开复位内固定术治疗胫骨平台骨折的临床疗效观察及术后功能恢复的影响因素分析[D].大连:大连医科大学,2013.
    [9] 徐超平,许关富,吕松浩,等.关节镜辅助下复位与切开复位内固定治疗SchatzkerⅢ型胫骨平台骨折的疗效比较[J].浙江临床学,2015,17(12):2101-2102.
    [10] KRAUSE M,PREISS A,MEENEN NM,et al.`Fracturoscopy` is superior to fluoroscopy in the articular reconstruction of complex tibial plateau fractures - an arthroscopy assisted fracture reduction technique [J].J Orthop Trauma,2016,30(8):437-444.
    [11] CARRERA I,GELBER PE,CHARY G,et al.Fixation of a split fracture of the lateral tibial plateau with a locking screw plate instead of cannulated screws would allow early weight bearing: a computational exploration[J].Int Orthop,2016,40(10):1-7.
    [12] HUANG X,ZHI Z,YU B,et al.Stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture:a comparative finite element study [J].J Orthop Surg & Res,2014,10(1):1-9.
    [13] 张克强,段洪,闵捷,等.三柱分型手术结合早期功能康复治疗复杂胫骨平台骨折57例疗效分析[J].中国骨与关节损伤杂志,2014,29(S1):32-33.
    [14] HUANG TW,LEE CY,CHEN SY,et al.Outcomes and second -look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5 -year minimal follow-up[J].BMC Musculoskelet Disord,2014(16):311.
    [15] 陈智华,林俊平,林深镇.胫骨平台骨折57例手术治疗及疗效探 讨[J].中国现代医生,2010,48(23):111-112.

上一篇颅脑外伤患者行网状与放射状硬膜切开减压的疗效对比分析

下一篇切开挂线对口引流术治疗高位复杂性肛瘘的临床疗效分析