锁定钢板与支撑钢板治疗复杂胫骨平台骨折的临床疗效分析

发布时间：2018-05-26 19:22

本文选题：胫骨平台骨折 + 骨折　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:比较支撑钢板与锁定钢板治疗复杂胫骨平台骨折的疗效。方法:选取在我院治疗的复杂胫骨平台骨折患者45例,时间为2011年9月~2014年2月,其中25例行双侧入路锁定钢板治疗,为A组,双侧支撑钢板内固定治疗20例,为B组。对比两组的术中出血量、手术时间、完全负重时间有无区别,最后一次随访应用Rasmussen评分标准对膝关节功能情况进行评估来比较两组的膝关节优良率。结果:术后定期对患者进行随访,1例失访,两组患者骨折均正常愈合,没有发生骨折延期愈合、不愈合情况;A组患者的手术时间(138.8±2.9)min、术中出血量(313.9±3.9)ml,B组患者的手术时间(136.7±3.3)min、术中出血量(317.1±3.8)ml,差异无有统计学意义(P0.05);但A组患者的完全负重时间(3.8±0.2)月明显短于B组的完全负重时间(4.7±0.3)月,A组膝关节功能优良率88%高于B组的70%,差异有统计学意义(P0.05)。结论:锁定钢板组更符合生物力学原则,完全负重时间明显早于支撑钢板组,有利于早期膝关节功能锻炼,膝关节优良率也高于支撑钢板组。相对于支撑钢板,锁定钢板在早期下地锻炼、改善膝关节功能方面有明显优势。
[Abstract]:Objective: to compare the curative effect of supporting plate and locking plate in the treatment of complex tibial plateau fracture. Methods: Forty-five patients with complex tibial plateau fractures treated in our hospital from September 2011 to February 2014 were selected. 25 cases were treated with locking plate with bilateral approach, group A and 20 cases with bilateral braced plate internal fixation. The amount of blood loss, time of operation and time of full weight bearing were compared between the two groups. The excellent and good rate of knee joint in the two groups was evaluated by using Rasmussen score in the last follow-up. Results: one patient was followed up regularly after operation. The fracture healed normally in both groups, and there was no delayed union. The operative time was 138.8 卤2.9 min in group A, 136.7 卤3.3 min in group B and 317.1 卤3.8 ml in group B, but the time of complete weight loading in group A was significantly shorter than that in group B (3.8 卤0.2) months. The excellent and good rate of knee joint function in group A was 88% higher than that in group B (4.7 卤0.3) months, and the difference was statistically significant (P 0.05). Conclusion: locking plate group is more in line with biomechanical principle, the time of full weight loading is earlier than that of support plate group, which is beneficial to early knee joint function exercise, and the excellent and good rate of knee joint is higher than that of support plate group. Compared with supporting plate, locking plate has obvious advantages in early exercise and improvement of knee joint function.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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