【摘要】 背景:胫骨近端关节内骨折是一种常见的骨折类型,临床治疗难度较大,其中植入物内固定是一种常用的修复方法。但对于最佳植入物内固定修复方案的选择,始终是临床研究的关键问题。目的:探讨不同植入物内固定对胫骨近端关节内骨折的修复效果,拟通过比较分析,得出较好的修复方案。方法:选择山西晋城市泽州县人民医院骨科、山西医科大学第二医院2010年9月至2013年9月收治的采用不同植入物内固定修复胫骨近端关节内骨折的患者32例,根据内固定方案分为两组,每组16例。观察组及对照组分别实施LISS锁定钢板和普通解剖钢板内固定治疗。观察两组出血量和手术时间、切口长度等;治疗结束后对患者进行12个月的随访,记录骨折愈合时间、完全负重时间及疗效优良率,并观察并发症发生情况,包括关节僵硬、松动、骨不连以及感染等。结果与结论:观察组的手术切口长度和手术时间均显著短于对照组,出血量显著小于对照组(P均<0.05)。在骨折愈合以及完全负重时间方面,观察组均显著短于对照组(P均<0.05)。观察组的并发症发生率为13%,显著低于对照组的46%(P<0.05)。修复疗效总优良率观察组显著高于对照组(94%,69%,P<0.05)。表明较之传统的解剖钢板,利用LISS锁定钢板内固定修复胫骨近端关节内骨折优势明显,可以最大程度减少对对软组织和骨折血运的损伤,促进骨折愈合,恢复关节的稳定性。更多还原

【Abstract】 BACKGROUND: The proximal tibial fractures within joint are a common type of fracture, and clinical treatment is difficult. The implant internal fixation is a commonly used method of treatment. However, the choice of the optimal implant internal fixation is always the key problem in clinical research. OBJECTIVE: To explore the curative effect of different implant internal fixation for the treatment of intra-articular proximal tibial fractures and to obtain the better treatment through the comparative analysis. METHODS: A total of 32 patients of intra-articular proximal tibial fracture, who were treated with different implant internal fixation for the treatment of proximal tibia, were selected from the Department of Orthopedics, People’s Hospital of Zezhou County of Jincheng City and Second Affiliated Hospital of Shanxi Medical University from September 2010 to September 2013. These patients were divided into two groups according to fixation methods(n=16). Observation and control groups received LISS locking plate and common plate, respectively. The amount of bleeding, operation time and incision length were observed in both groups. Patients were followed up for 1 to 12 months after treatment so as to record fracture healing time, full weight bearing time and excellent and good rateand to observe the incidence of complications, including joint stiffness, loosening, nonunion and infection. RESULTS AND CONCLUSION: Incision length and operation time in the observation group were significantly shorter than that in the control group, and the amount of bleeding was significantly lower in the observation group than that of control group(all P < 0.05). The healing of fracture and the full weight bearing time were significantly shorter in the observation group than that in the control group(both P < 0.05). The incidence of complications was significantly lower in the observation group(13%) than in the control group(46%; P < 0.05). The total excellent and good rate of repair was significantly higher in the observation group than in the control group(94%, 69%, P < 0.05). These results confirm that compared with the traditional plate fixation, internal fixation with LISS locking plate for treating intra-articular proximal tibial fractures can get better therapeutic effects, greatly reduces the injuries to soft tissue and fracture blood supply, promotes fracture healing and restores joint stability.更多还原