锁定加压钢板与解剖钢板置入内固定治疗复杂胫骨平台骨折

背景:对于治疗复杂胫骨平台骨折,锁定钢板与普通钢板均可应用。目的:比较锁定钢板与普通解剖型钢板置入内固定治疗复杂胫骨平台骨折疗效的差异。方法:2007年6月至2010年6月应用胫骨近端钢板治疗复杂胫骨平台骨折118例,其中锁定加压钢板46例,解剖钢板72例。比较两种钢板置入内固定治疗复杂胫骨平台骨折的愈合时间及膝关节功能恢复情况。结果与结论:所有胫骨平台骨折均愈合,骨折愈合时间为10-25周,锁定钢板组平均14周,解剖钢板组平均16周;两组差异有显著性意义(P<0.01)。两组内固定后各有2例因开放性骨折切口感染,运用抗生素及伤口换药后愈合,1例出现筋膜间室综合征(解剖钢板组,内固定后),经切开减压后渐愈。解剖钢板组出现轻度膝内翻2例,锁定钢板组出现轻度膝内翻1例。按Karlstrom评估标准,锁定钢板组优良率为93%,解剖钢板组优良率为79%,锁定钢板组疗效优良率明显优于解剖钢板组(P<0.05)。可见对于治疗复杂胫骨平台骨折,锁定钢板比普通钢板有更多优势。

Locking compression plate and anatomical type plate fixation for the treatment of complex fracture of tibial plateau

BACKGROUND： Both locking plate and ordinary steel plate internal fixation can be used for the treatment of the complex fracture of tibial plateau. 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： 118 cases of complex fracture of tibial plateau were treated with proximal tibial plate from June 2007 to June 2010. Forty-six cases were treated with locking compression plate and 72 cases were treated with anatomical type plate. The healing time and the recovery of knee function were compared after locking compression plate and atomical type plate internal fixation for the treatment of complex fracture of tibial plateau. RESULTS AND CONCLUSION： All the fractures of tibial plateau were healed, and the healing time was 10 to 25 weeks, the average healing time in locking plate group was 14 weeks and the the average healing time in anatomical type plate group was 16 weeks; there was no significant difference of the healing time between two groups （P 0.01）. There were two cases of open fractures incision infection in each group and healed after antibiotics application and change dressing; one case had fascia compartment syndrome in anatomical type plate group after internal fixation, and the fracture was gradually healed after incision and decompression. There were two cases of mild knee varus in anatomical type plate group and one case in locking plate group. According to the Karlstrom evaluation standard, the excellent and good rate of locking plate group was 93% and the anatomical type plate group was 79%, the excellent and good rate of locking plate group was significantly better than that of the anatomical type plate group （P 0.05）. For the treatment of complex fracture of tibial plateau, the locking plate has more advantages than ordinary anatomical type plate anatomical type plate.