CAJ | 학술논문

目的：比较解剖钢板与锁定加压钢板治疗复杂开放性胫骨平台骨折的临床效果。方法选择承德医学院附属医院2010年1月~2014年1月收治的复杂开放性胫骨平台骨折患者108例,按随机数字表法分为观察组和对照组,每组各54例。对照组采用胫骨近端解剖钢板固定治疗,观察组采用胫骨近端锁定加压钢板内固定治疗。观察两组患者内固定手术时间、手术出血量、骨折愈合时间、并发症及膝关节功能优良率。结果两组患者的手术时间、术中出血量差异无统计学意义(P>0.05)；观察组的骨折愈合时间为(14.2±2.7)周,对照组的骨折愈合时间为(16.9±3.1)周,观察组的完全负重时间为(18.2±3.3)周,对照组的完全负重时间为(21.1±3.6)周,观察组的骨折愈合时间与完全负重时间均少于对照组,差异有高度统计学意义(P<0.01)。观察组1例患者出现筋膜间室综合征,对照组2例患者出现筋膜间室综合征,1例患者出现膝内翻,1例患者出现切口感染,观察组并发症发生率低于对照组,但差异无统计学意义(P>0.05)；观察组的优良率为92.59%,对照组的优良率为77.78%,差异有统计学意义(P<0.05)。结论与解剖钢板相比,锁定加压钢板具有缩短骨折部位愈合时间,使患者完全负重时间提前,降低术后并发症发生率,提高手术优良率等优点,值得临床推广使用。
목적：비교해부강판여쇄정가압강판치료복잡개방성경골평태골절적림상효과。방법선택승덕의학원부속의원2010년1월~2014년1월수치적복잡개방성경골평태골절환자108례,안수궤수자표법분위관찰조화대조조,매조각54례。대조조채용경골근단해부강판고정치료,관찰조채용경골근단쇄정가압강판내고정치료。관찰량조환자내고정수술시간、수술출혈량、골절유합시간、병발증급슬관절공능우량솔。결과량조환자적수술시간、술중출혈량차이무통계학의의(P>0.05)；관찰조적골절유합시간위(14.2±2.7)주,대조조적골절유합시간위(16.9±3.1)주,관찰조적완전부중시간위(18.2±3.3)주,대조조적완전부중시간위(21.1±3.6)주,관찰조적골절유합시간여완전부중시간균소우대조조,차이유고도통계학의의(P<0.01)。관찰조1례환자출현근막간실종합정,대조조2례환자출현근막간실종합정,1례환자출현슬내번,1례환자출현절구감염,관찰조병발증발생솔저우대조조,단차이무통계학의의(P>0.05)；관찰조적우량솔위92.59%,대조조적우량솔위77.78%,차이유통계학의의(P<0.05)。결론여해부강판상비,쇄정가압강판구유축단골절부위유합시간,사환자완전부중시간제전,강저술후병발증발생솔,제고수술우량솔등우점,치득림상추엄사용。
Objective To observe the effect of locking plate and ordinary anatomical type plate internal fixation for the treatment of complex fracture of tibial plateau. Methods From January 2010 to January 2014, in the Affiliated Hospital of Chengde Medical University, 108 patients with omplex fracture of tibial plateau were selected, according to random number table method, they were divided into observation group and control group, with 54 cases in each group. The ob-servation group was treated with locking compression plate, and the control group were treated with anatomical type plate. The time of operation, intraoperative blood loss, time of fracture healing, incidence of adverse reactions, excellent and good rate of the knee joint of patients in two groups were compared. Results The operation time and intraoperative blood loss of two groups were compared, the differences were not statistically significant (P>0.05);the fracture healing time of the observation group was (14.2±2.7) weeks, that of the control group was (16.9±3.1) weeks, the full weight-bear-ing time of the observation group was (18.2±3.3) weeks, that of the control group was (21.1±3.6) weeks, the fracture heal-ing time and full load time of the observation group were less than those of the control group, the differences were sta-tistically significant (P< 0.05). The fascia compartment syndrome of the observation group was 1 case, in the control group, fascia compartment syndrome were 2 cases, knee varus was 1 case, infection of incision was 1 cases, the compli-cations rate of the observation group was less than that of the control group, but the difference was not statistically sig-nificant (P> 0.05); the excellent and good rate of observation group was 92.59%, the control group was 77.78%, the difference was statistically significant (P< 0.05). Conclusion Compared with the ordinary anatomical type plate inter-nal fixation, locking plate has the advantages of shorter fracture healing time, making the patient completely load ahead of time, reducing the incidence of postoperative complications and improving the rate of the excellent and good, it is worth of clinical using.