锁定钢板与普通解剖型钢板置入治疗复杂胫骨平台骨折的疗效和安全性比较

目的 分析锁定钢板与普通解剖型钢板置入治疗复杂胫骨平台骨折的疗效和安全性.方法 选择我院2008年5月至2010年11月收治的80例胫骨平台骨折患者,分别采用锁定钢板（观察组,n=42）或普通解剖型钢板（对照组,n=38）内固定治疗,对两组患者的临床资料进行回顾性分析.结果 观察组患者的手术时间为（84.23±8.13） min、术中出血量为（68.17±7.54） ml、切口长度为（9.54±1.34） cm、疼痛持续时间为（2.39±0.43）d、住院时间为（9.45±2.31）d、术后负重时间为（97.39±16.57）d、骨折愈合时间为（89.64±19.45）d、解剖复位率为97.50％、早期并发症发生率为0、晚期并发症发生率为2.50％、治疗优良率为85.71％.对照组患者的手术时间为（86.53±9.43） min、术中出血量为（65.09±8.67） ml、切口长度为（9.35±0.98） cm、疼痛持续时间为（2.43±0.36）d、住院时间为（17.23±3.83）d、术后负重时间为（124.98±25.23）d、骨折愈合时间为（115.88±13.82）d、解剖复位率为97.37％、早期并发症发生率为2.63％、晚期并发症发生率为7.89％,治疗优良率为73.68％.观察组患者的住院时间、术后负重时间、骨折愈合时间、解剖复位率、早期并发症发生率、晚期并发症发生率和疗效都显著优于对照组患者（P＜0.05）,但两组患者的手术时间、出血量、切口长度、疼痛持续时间差异均无统计学意义（P＞0.05）.结论 与普通解剖型钢板内固定治疗比较,锁定钢板内固定治疗复杂胫骨平台骨折疗效确切,安全可靠,可以作为治疗胫骨平台骨折的首选方法.

Clinical effects and safety of locking plate fixation or ordinary type anatomical steel plate for the treatment of complex tibial plateau fractures

Objective To analyze the clinical effects and safety of locking plate fixation or ordinary type anatomical steel plate for the treatment of complex tibial plateau fractures.Methods The clinical data of the locking plate fixation （observation group,n=42） or ordinary type anatomical steel plate （control group,n=38） for treatment of 80 patients with fracture of tibial plateau were analyzed retrospectively from May 2008 to November 2010.Results The operation time were （84.23±8.13） min and （86.53±9.43） min,the peri-operative bleeding amount were （68.17±7.54） ml and （17.23±3.83） ml,the length of incision were （9.54± 1.34） cm and （9.35±0.98） cm,the pain duration were （2.39±0.43） d and （2.43±0.36） d,the length of hospital stay were （9.45±2.31） d and （17.23±3.83） d,the load time were （97.39±16.57） d and （124.98±25.23） d,the healing time were （89.64± 19.45） d,and （115.88± 13.82） d,the anatomy reset rate were 97.50% and 97.37%,the early complication rate were 0% and 2.63%,the laster complication rate was 2.50% and 2.50%,and the curative effect rate were 90.00% and 73.68% in the observation group and control group,respectively.The length of hospital stay,the load time,the healing time,the complication rate,and the curative effect in the observation group were significantly better than those in the control group （P〈0.05）.However,there were no significant differences in the operation time,the peri-operative bleeding,the length of incision,the pain duration,and the anatomy reset rate between the two groups.Conclusion Compared with ordinary type anatomical steel plate,the locking plate fixation is effective and safe for the treatment of complex tibial plateau fractures.