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有限内固定联合外固定与钢板内固定治疗胫骨平台骨折的比较
Comparison of limited internal fixation combined with external fixator and internal plate fixation for tibial plateau fractures
  
DOI:
中文关键词:  胫骨平台骨折  内固定器  外固定器
英文关键词:Tibial fractures  Internal fixators  External fixators
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作者单位
赵衍听 田家祥 刘莉 冯久坤  
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中文摘要:
      目的 比较有限内固定联合外固定支架与切开复位钢板内固定治疗Schatzker Ⅵ型胫骨平台骨折的临床疗效。方法 2010年1月至2014年1月我院收治的55例Schatzker Ⅵ型胫骨平台骨折患者,根据治疗方式的不同分为联合组(采用有限内固定联合外固定支架治疗)和钢板组(采用切开复位钢板内固定治疗)。比较两组手术时间、出血量、住院天数、切口并发症、骨折愈合时间、膝关节疼痛(visual analogue score, VAS)及膝关节功能(Rasmussen评分)。结果 联合组手术时间(t = 7.230,P <0.01)、出血量(t = 8.084,P<0.01)、住院天数(t =5.505,P <0.01)及骨折愈合时间(t=2.871,P<0.01)均显著少于钢板组。钢板组术后切口并发症发生率(38.2%)显著高于联合组(9.5%)(P<0.05)。末次随访时,两组患者VAS评分与Rasmussen评分等差异无统计学意义(P>0.05)。结论 采用有限内固定联合外固定支架治疗或切开复位钢板内固定治疗Schatzker Ⅵ型胫骨平台骨折,均可获得满意临床疗效,但前者具有创伤较小、切口并发症发生率低、住院天数较短、骨折愈合快等优点。
英文摘要:
      Objective To compare the clinical and radiological outcomes of limited internal fixation combined with external fixator and open reduction-internal plate fixation for tibial plateau fracture of Schatzker Ⅵ. Methods 55 patients with tibial plateau fractures of Schatzker Ⅵ which were divided into the combining group (accepting limited internal fixation combined with external fixator) and the plate group (accepting open reduction and internal plate fixation). The following data were compared between the two groups: the operation time, blood loss, the length of hospital stay, the incidence of wound complications, the time of fracture union, visual analogue score (VAS) of knee pain. Rasmussen score for clinical function evaluation. Results The operation time (t= 7.230, P<0.01), blood loss (t=8.084, P<0.01), the length of hospital stay (t= 5.505, P<0.01), and the time of fracture union (t=2.871, P<0.01) in the combining group were significantly less than those in the plate group (P<0.05). The incidence of wound complication in plate group was 38.2%, which were significantly high, when compared with those in the combined group (9.5%) (P<0.05). There were no significant difference between the combined group and plate group in term of VAS, and Rasmussen score (P>0.05). Conclusion The use of limited internal fixation combined with external fixator or open reduction and plate internal fixation for the tibial plateau fracture of Schatzker Ⅵ, can achieve satisfactory clinical and radiographic results, but the former has the advantage of less invasive procure, lower incidence of wound complication, shorter length of hospital stay, and shorter time of fracture union.
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