解剖钢板、锁定钢板和双切口双钢板治疗胫骨平台骨折效果比较

目的比较解剖钢板、锁定钢板和双切口双钢板治疗胫骨平台骨折的方法和临床效果。方法将129例胫骨平台骨折患者分为A、B、C三组，每组各43例。A组选用解剖钢板方法，B组选用双切口双钢板方法。C组选用锁定钢板内固定方法。术后比较各组患者胫骨平台内翻角（TPA）、后倾角（PA），以及膝关节活动度、膝关节功能评分（HSS）、骨折愈合时间。结果三组患者术后1d、9个月、15个月TPA、PA比较，术后患膝关节活动度、术后15个月HSS值、骨折愈合时间比较，各组间差异均无统计学意义（P〉0．05）。结论解剖钢板、锁定钢板和双切口双钢板治疗胫骨平台骨折稳定性和疗效基本相当，在胫骨平台骨折手术治疗时．可参照医疗技术水平、术者手术经验、患者经济承受能力和意愿等因素来选择适当的手术方式。

Curative effect comparison on treating tibia plateau fracture among anatomical plate, locking plates and double plates fixation

Objective To compare the methods and clinical effects of treating tibia plateau fracture among anatomical plate, locking plates and double plates fixation. Methods 129 cases of patients with tibial plateau fracture were divided into group A, B and C, 43 cases per group. The patients in group A were treated by anatomical plate, group B were treated by double plates fixation, and group C were treated by locking plate fixation. Tibial plateau varus angle （TPA）, posterior slope angle （PA）, knee joint motion, knee function scores and fracture healing time were compared among three groups after operation. Results There were all no statistical difference among three groups on comparisons of TPA and PA 1 day, 9 months and 15 months after operation, knee joint motion after operation, HSS score 15 months after operation and fracture healing time （P 〉 0.05）. Conclusion Anatomical plate, locking plates and double plates fixation provides similar mechanical stability and clinical effect on treating tibia plateau fracture, so it can refer to doctors＇ technology, experience, the patients＇ economy and willingness to choose appropriate operation method.