单侧锁定钢板与双钢板内固定治疗复杂型胫骨平台骨折的疗效对比分析

发布时间：2018-11-24 07:33

【摘要】：背景/目的:比较双切口双钢板与单侧锁定钢板内固定治疗复杂型胫骨平台骨折的疗效。方法:回顾性分析我院自2009年6月至2014年6月间治疗的102例复杂型胫骨平台骨折患者的临床资料,根据术前CT表现的不同,其中54位(54%)患者采用双钢板治疗,为A组,48位(46%)患者采用锁定钢板治疗,其中22位(22%)含有冠状位骨折线,为B组,26位(24%)不含冠状位骨折线,为C组,观察比较三组的手术效果。结果:三组的伤口感染率、骨折不愈合发生率、术后即刻的X线显示复位不良的发生率比较,差异无统计学意义(P0.05),骨折愈合后(6个月以上)的X线显示新出现的复位不良的发生率的比较,差异有统计学意义(P0.05)。两两对比时可见B组骨折愈合后的X线显示复位不良的发生率明显高于其他两组,差异有统计学意义(P0.05)。结论:对于大多数复杂型胫骨平台骨折而言,单纯外侧锁定钢板能有效固定骨折并获得良好的疗效。但内侧髁合并冠状位骨折的病例以单纯外侧锁定钢板固定后骨折复位丢失的发生率较高,在软组织条件允许的条件下建议使用双钢板。
[Abstract]:Background / AIM: to compare the efficacy of double incision plate and unilateral locking plate in the treatment of complex tibial plateau fractures. Methods: the clinical data of 102 patients with complex tibial plateau fractures treated in our hospital from June 2009 to June 2014 were retrospectively analyzed. According to the different CT findings before operation, 54 patients (54%) were treated with double plate. 48 cases (46%) were treated with locking plate, 22 cases (22%) had coronal fracture line, 26 cases (24%) had no coronal fracture line. Results: there was no significant difference in the rate of wound infection, the incidence of fracture nonunion and the incidence of poor reduction by X-ray immediately after operation (P0.05). After fracture healing (more than 6 months) X-ray showed the incidence of new bad reduction, the difference was statistically significant (P0.05). In contrast, the incidence of poor reduction in group B was significantly higher than that in other two groups, the difference was statistically significant (P0.05). Conclusion: for most complex tibial plateau fractures, only lateral locking plate can effectively fix the fractures and obtain good results. However, the incidence of loss of reduction in patients with medial condylar fracture complicated with coronal fracture was higher after fixation with only lateral locking plate. Double plate should be used when soft tissue conditions permit.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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