内外固定结合与双侧钢板内固定治疗复杂胫骨平台骨折的临床对比研究

Therapeutic effect of limited internal fixation combined with external fixation and bilateral inside-fixed steel for complex tibial plateau fractures: a controlled clinical study

摘要:

目的 比较内外固定结合（有限内固定结合外固定支架）与双侧钢板内固定在治疗复杂性胫骨平台骨折治疗中的疗效及安全性。方法 选取2013 年8 月-2016 年8 月于该院接受复杂胫骨平台骨折手术的患者共68 例，将其随机分为两组。其中观察组36 例，采用内外固定结合手术治疗，对照组32 例，采用双侧钢板内固定手术。观察术中情况、术后并发症、骨折愈合时间及膝关节功能评分等。结果 两组患者在手术时间、术中出血量、骨折愈合时间及膝关节功能评分等方面比较，差异有统计学差异（P <0.05），观察组优于对照组。术后并发症方面，两组仅切口感染比较，差异有统计学意义（P <0.05），观察组优于对照组，而延迟愈合和创伤性关节炎两组比较，差异无统计学意义（P >0.05）。结论 与双侧钢板内固定相比，内外固定结在治疗复杂性胫骨平台骨折中安全有效，且并发症较少。

Abstract:

Objective To compare the therapeutic effect and safety of limited internal fixation combined with external fixation and bilateral inside-fixed steel for complex tibial plateau fractures. Methods Sixty-eight patients with complex tibial plateau fractures, who had surgery in our hospital from August 2013 to August 2016, were selected and randomly divided into experimental group (36 cases) and control group (32 cases). The patients in the experimental group were treated with limited internal fixation combined with external fixation and those in the control group were given internal fixation with bilateral steel plates. The operative situation, fracture healing time, complications and knee functional scores were observed. Results There were statistical differences in the operation time, intraoperative blood loss, fracture healing time and knee functional scores between the two groups (P < 0.05).However, as to postoperative complications only infective of operation incision was significantly different between the two groups (P > 0.05). Conclusions Compared with the bilateral inside-fixed steel, limited internal fixation combined with external fixation is safe and effective in the treatment of complex tibial plateau fractures, and there are fewer complications.