双切口双钢板内固定术对Schatzker V型胫骨平台骨折患者骨折愈合及关节稳定性的影响

摘要/Abstract

摘要： 目的探讨双切口双钢板内固定术对Schatzker V型胫骨平台骨折患者骨折愈合及关节稳定性的影响。方法回顾性分析2020年1月—2022年12月日照市人民医院收治的60例Schatzker V型胫骨平台骨折患者的临床资料,按手术方式不同将双切口双钢板内固定术治疗的30例患者设为观察组,将单侧锁定钢板固定术治疗的30例患者设为对照组。比较两组手术相关指标、膝关节功能、关节稳定性、日常生活能力、平衡能力、生活质量及并发症。结果两组患者手术时间、切口长度、术后住院时间比较,差异无统计学意义（P>0.05）;观察组患者术中出血量、术后引流量多于对照组,骨折愈合时间短于对照组,差异有统计学意义（P<0.05）;观察组患者术后3个月骨关节炎指数（WOMAC）中日常生活、疼痛、关节畸形及总分均低于对照组,差异有统计学意义（P<0.05）;观察组患者术后3个月胫骨平台内翻角（TPA）、胫骨平台后倾角（PA）低于对照组（P<0.05）;观察组患者术后3个月Barthel指数（BI）评分、Berg平衡量表（BBS）评分高于对照组,差异有统计学意义（P<0.05）;观察组患者术后3个月世界卫生组织生活简易量表（WHOQOL-BREF）中生理、心理、社会及环境领域评分高于对照组,差异有统计学意义（P<0.05）;两组并发症发生率比较,差异无统计学意义（P>0.05）。结论双切口双钢板内固定术治疗Schatzker V型胫骨平台骨折效果更佳,可提高关节稳定性,缩短骨折愈合时间,增强日常活动能力,安全可靠。

关键词: 胫骨平台骨折, 双切口双钢板内固定术, 单侧锁定钢板固定术, 关节稳定性, 并发症

Abstract: Objective To investigate the effect of double incision and double plate internal fixation on fracture union and joint stability of Schatzker V-type tibial plateau fracture. Methods Clinical data of 60 patients with Schatzker V-type tibial plateau fracture admitted to Rizhao People's Hospital from January 2020 to December 2022 were retrospectively analyzed. According to different surgical methods, 30 patients treated with double incision and double plate internal fixation were set as the observation group, and 30 patients treated with unilateral locking plate fixation were set as the control group. The operation related indexes, knee function, joint stability, daily living ability, balance ability, quality of life and complications were compared between the two groups. Results There was no significant difference in operation time, incision length and postoperative hospital stay between the two groups (P>0.05). The intraoperative blood loss and postoperative drainage volume in the observation group were higher than those in the control group, and the fracture healing time was shorter than that in the control group (P<0.05). The daily life, pain, joint deformities and total score of WOMAC in the observation group were lower than those in the control group 3 months after surgery, and the difference was statistically significant (P<0.05). The TPA and PA of the observation group were lower than those of the control group 3 months after operation (P<0.05); The BI scores and BBS scores of the observation group were higher than those of the control group 3 months after operation (P< 0.05). The WHOQOL-BREF scores in the observation group were higher than those in the control group at 3 months after operation(P<0.05). There was no significant difference in complications between the two groups (P>0.05). Conclusion Double incision and double plate internal fixation for the treatment of Schatzker V-type tibial plateau fracture is more effective, which can improve joint stability, shorten fracture healing time, enhance daily activity ability, and is safe and reliable.

Key words: tibial plateau fracture, double incision and double plate internal fixation, unilateral locking plate fixation, joint stability, complication

中图分类号:

R687.3

杨金虎, 杨大雷. 双切口双钢板内固定术对Schatzker V型胫骨平台骨折患者骨折愈合及关节稳定性的影响[J]. 中华养生保健, 2024, 42(3): 49-53.

YANG Jin-hu, YANG Da-lei. Effect of Double Incision and Double Plate Internal Fixation on Fracture Union and Joint Stability of Schatzker V-type Tibial Plateau Fracture[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(3): 49-53.

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