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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:

期数:

2024年03期

页码:

159-164

栏目:

下肢

出版日期:

2024-06-05

文章信息/Info

Title:

The safety and mid-term and long-term prognosis of the treatment of complex tibial plateau fractures above Schatzker type IV with double incision and double plate internal fixation

作者:

郭昆; 杨晓峰; 李传明

221000 徐州市肿瘤医院骨科

Author(s):

Guo Kun;  Yang Xiaofeng;  Li Chuanming

Department of Orthopedics, Xuzhou Cancer Hospital, Xuzhou 221000, China

关键词:

双切口双钢板内固定;  SchatzkerⅣ型;  复杂胫骨平台骨折;  安全性;  远期预后

Keywords:

Double incision and double steel plate internal fixation;  Schatzker type Ⅳ;  Complex tibial plateau fractures;  Safety;  Long term prognosis

DOI:

DOI：10.3877/cma.j.issn.2096-0263.2024.03.006

文献标志码:

A

摘要:

目的 探讨Schatzker Ⅳ型以上复杂胫骨平台骨折患者实施双切口双钢板内固定治疗的安全性及对远期预后的改善效果。方法 采集2021年9月至2022年9月病例资料入档，对象为医院收治的Schatzker Ⅳ型以上复杂胫骨平台骨折患者共计纳入100例，纳入对象基于“随机数字表法”1:1分组，划分为对照组（实行单侧锁定钢板内固定术）与观察组（实行双钢板双切口内固定术），各组均纳入50例；观察对比两组手术相关指标、影像学指标、膝关节功能、并发症发生率。结果 两组患者的手术用时比较，差异无统计学意义（P＞0.05），观察组完全负重时间、住院时间短于对照组，术中出血量相对多，骨折愈合时间相对长（P＜0.05）；术后6个月，两组胫骨平台内翻角、后倾角均升高，且观察组较对照组更高（P＜0.05）；术后6个月，两组患者HSS评分均呈一定升幅，且观察组升幅较对照组更大（P＜0.05）；观察组并发症发生率较对照组明显低（P＜0.05）。结论 Schatzker Ⅳ型以上复杂胫骨平台骨折实行双切口双钢板内固定术，相较于单侧锁定钢板内固定术，更利于维持膝关节稳定性，便于术后早期运动锻炼，促进关节功能恢复，且降低相关并发症风险，取得理想预后结果。

Abstract:

Objective To explore the safety and improvement of long-term prognosis of Schatzker IV and above complex tibial plateau fractures treated with double incision and double plate internal fixation. Methods Case data were collected and recorded from September 2021 to September 2022. A total of 100 patients with Schatzker type IV or above complex tibial plateau fractures admitted to the hospital were included. The participants were divided into a control group (performing unilateral locking steel plate internal fixation) and an observation group (performing double plate and double incision internal fixation) based on a 1:1 random number table method, with 50 patients included in each group; Observe and compare the surgical related indicators, imaging indicators, knee joint function, and incidence of complications between the two groups. Results The comparison of surgical time between the two groups of patients (P>0.05) showed that the observation group had shorter complete weight-bearing time and hospital stay than the control group, relatively more intraoperative bleeding, and relatively longer fracture healing time (P<0.05); At 6 months after surgery, the tibial plateau varus angle and posterior inclination angle increased in both groups, and the observation group was higher than the control group (P<0.05); Six months after surgery, the HSS scores of both groups of patients showed a certain increase, and the increase in the observation group was greater than that in the control group (P<0.05); The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusions The implementation of double incision and double plate internal fixation for complex tibial plateau fractures of Schatzker type Ⅳ and above is more conducive to maintaining knee joint stability, facilitating early postoperative exercise, promoting joint function recovery, and reducing the risk of related complications compared to unilateral locking plate internal fixation, achieving ideal prognosis results.

备注/Memo

备注/Memo:

基金项目：徐州市推动科技创新专项资金项目（KC19188）

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更新日期/Last Update: 2024-09-03