解剖型钢板与锁定加压钢板治疗胫骨下段粉碎性骨折比较

目的 比较解剖型钢板（AP）与锁定加压钢板（LCP）治疗胫骨下段粉碎性骨折的疗效。方法58例胫骨下段粉碎性骨折患者随机分为两组，分别采用AP与LCP固定，比较手术操作时间、手术出血量、术后平均骨折愈合时间、石膏固定时间、骨折对线情况等。结果AP与LCP平均手术时间分别为（48．5±5．5）min和（46．8±4．8）min；平均出血量分别为（65±4）ml和（35±5）ml；平均骨折愈合时间分别为（16．1±0．6）周和（11．8±0．5）周，平均石膏固定时间分别为（26±4）d和（17±3）d。骨折愈合对线情况：正位片成角AP组（3．5±0．7）°，LCP组（1．8±0．6）°；侧位片成角AP板组（2．7±0．4）°，LCP组（1．6±0．3）°。两组比较，除手术时间外，各项指标差异均有显著性（P〈0．01）。结论LCP治疗胫骨骨折比AP手术效果优越。

Comparison of the treatment of distal tibial fracture with anatomical plate and locking compression plate

Objective To investigate the outcome of distal tibial shaft comminuted fracture treated with anatomical plate （AP） and locking compression plate （LCP）. Methods 58 cases of distal tibial shaft fractures were divided randomly into 2 groups of A and B. Group A were fixed with AP and Group B with LCP. The operation time, blood loss, time of fracture healing, time of plaster fixation and the alignment of the shaft were analyzed respectively. Resuits The average operation time was （48.5±5.5 ） min for AP and （46. 8 ± 4. 8） rain for LCP; the average blood loss was （65 ±4） ml for AP and （35 ±5） ml for LCP, the average time of fracture healing was （ 16. 1±0. 6） weeks for AP and （ 11.8 ±0. 5） weeks for LCP; and the time of plaster fixation was （26 ±4） d for AP and （ 17 ±3） d for LCP. The angulation in anterior posterior films was （3.5 ±0. 7） °for AP and （ 1.8 ±0.6） °for LCP; in lateral films, it was （2.7 ±0.4）° for AP and （ 1.6 ±0. 3） °for LCP. Comparing the two groups, with the exception of surgery time, the indicators were significant different（ P 〈 0. 01 ）. Conclusions It is more convenient to fix the tibial shaft fracture with LCP than with AP, and the outcome of LCP is better than that of AP.