中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
35期
5616-5621
,共6页
植入物%骨植入物%胫骨平台骨折%锁定钢板%支持钢板
植入物%骨植入物%脛骨平檯骨摺%鎖定鋼闆%支持鋼闆
식입물%골식입물%경골평태골절%쇄정강판%지지강판
tibial fractures%internal fixators%fracture healing%fol ow-up studies
背景：胫骨平台骨折采用单侧支持钢板容易形成偏心支撑，易导致成角畸形，而若仅用外侧支持钢板又容易出现膝关节内翻畸形。目的：比较双切口外侧锁定钢板联合内侧支持钢板与双支持钢板内固定修复复杂胫骨平台骨折的临床及影像学效果。方法：回顾性分析2009年3月至2013年11月收治86例复杂胫骨平台骨折患者的临床资料。根据其内固定方式分为2组，外锁定内支持组采用外侧锁定钢板固定骨折情况相对较复杂及粉碎程度较重的外侧，内侧采用支撑钢板；内外支持组则内外侧均采用支撑钢板固定。术后随访2年，对比两种内固定方式的临床及影像学效果。结果与结论：所有随访患者创口均Ⅰ期愈合，骨折均获得骨性愈合。两组患者的手术时间、上止血带时间及术中出血量比较差异均无显著性意义(P>0.05)。术后随访发现，除完全负重时间外锁定内支持组明显早于双支持钢板组外(P<0.05)，两组骨折愈合时间、膝关节功能评分、膝关节活动度、术后胫骨平台内翻角、胫骨平台后倾及术后1年胫骨平台内翻角、胫骨平台后倾差异均无显著性意义(P>0.05)。提示双切口双钢板置入内固定修复胫骨平台骨折具有良好的临床及影像学效果，与双支持钢板相比，外侧锁定钢板联合内侧支持钢板在完全负重时间上更具优势。
揹景：脛骨平檯骨摺採用單側支持鋼闆容易形成偏心支撐，易導緻成角畸形，而若僅用外側支持鋼闆又容易齣現膝關節內翻畸形。目的：比較雙切口外側鎖定鋼闆聯閤內側支持鋼闆與雙支持鋼闆內固定脩複複雜脛骨平檯骨摺的臨床及影像學效果。方法：迴顧性分析2009年3月至2013年11月收治86例複雜脛骨平檯骨摺患者的臨床資料。根據其內固定方式分為2組，外鎖定內支持組採用外側鎖定鋼闆固定骨摺情況相對較複雜及粉碎程度較重的外側，內側採用支撐鋼闆；內外支持組則內外側均採用支撐鋼闆固定。術後隨訪2年，對比兩種內固定方式的臨床及影像學效果。結果與結論：所有隨訪患者創口均Ⅰ期愈閤，骨摺均穫得骨性愈閤。兩組患者的手術時間、上止血帶時間及術中齣血量比較差異均無顯著性意義(P>0.05)。術後隨訪髮現，除完全負重時間外鎖定內支持組明顯早于雙支持鋼闆組外(P<0.05)，兩組骨摺愈閤時間、膝關節功能評分、膝關節活動度、術後脛骨平檯內翻角、脛骨平檯後傾及術後1年脛骨平檯內翻角、脛骨平檯後傾差異均無顯著性意義(P>0.05)。提示雙切口雙鋼闆置入內固定脩複脛骨平檯骨摺具有良好的臨床及影像學效果，與雙支持鋼闆相比，外側鎖定鋼闆聯閤內側支持鋼闆在完全負重時間上更具優勢。
배경：경골평태골절채용단측지지강판용역형성편심지탱，역도치성각기형，이약부용외측지지강판우용역출현슬관절내번기형。목적：비교쌍절구외측쇄정강판연합내측지지강판여쌍지지강판내고정수복복잡경골평태골절적림상급영상학효과。방법：회고성분석2009년3월지2013년11월수치86례복잡경골평태골절환자적림상자료。근거기내고정방식분위2조，외쇄정내지지조채용외측쇄정강판고정골절정황상대교복잡급분쇄정도교중적외측，내측채용지탱강판；내외지지조칙내외측균채용지탱강판고정。술후수방2년，대비량충내고정방식적림상급영상학효과。결과여결론：소유수방환자창구균Ⅰ기유합，골절균획득골성유합。량조환자적수술시간、상지혈대시간급술중출혈량비교차이균무현저성의의(P>0.05)。술후수방발현，제완전부중시간외쇄정내지지조명현조우쌍지지강판조외(P<0.05)，량조골절유합시간、슬관절공능평분、슬관절활동도、술후경골평태내번각、경골평태후경급술후1년경골평태내번각、경골평태후경차이균무현저성의의(P>0.05)。제시쌍절구쌍강판치입내고정수복경골평태골절구유량호적림상급영상학효과，여쌍지지강판상비，외측쇄정강판연합내측지지강판재완전부중시간상경구우세。
BACKGROUND:Unilateral support plate in the treatment of complex tibial plateau fractures easily formed eccentrical y brace, and easily led to angular deformity. The outer support plate alone is prone to knee varus deformity. OBJECTIVE:To compare the clinical and imaging effects with the outer locking plate combined with inner support plate fixation and double support plate using dual lateral incision in the repair of complex tibial plateau fracture. METHODS:We retrospectively analyzed the clinical data of 86 patients with complex tibial plateau fractures from March 2009 to November 2013. According to the different fixations, patients were divided into two groups. Outer locking plate combined with inner support plate group:lateral locking plate fixation for complex and comminuted fractures, and support plate was used in the inner side. Double support plate group used internal and external support plates. Patients were fol owed up for 2 years after the surgery. Clinical and imaging effects of two different fixations were compared. RESULTS AND CONCLUSION:Wounds were stage I healing in al the fol ow-up patients. Bone healing was conducted. No significant difference in operation time, time of tourniquet and intraoperative blood loss was detectable between both groups (P>0.05). Postoperative fol ow-up demonstrated that ful load time was significantly earlier in the outer locking plate combined with inner support plate group than in the double support plate group (P<0.05). No significant difference in fracture healing time, hospital for special surgery score, range of knee motion and postoperative tibial plateau angle, posterior slope angle and postoperative 1 year tibial plateau angle, posterior slope angle was detected between the two groups (P>0.05). These data confirmed that dual lateral incision double plate fixation in the repair of tibial plateau fractures had wel clinical and imaging features. Compared with the double support plates, outer locking plate combined with inner support plate has superiority in ful load time.
