后置钢板固定前侧软组织损伤的胫骨中远端骨折

Posterior plate placement for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury

摘要:

［目的］ 探讨后置钢板在治疗伴有前侧软组织损伤的胫骨中远端骨折的临床效果。［方法］ 2014 年 7 月—2021 年 6 月，对伴有前侧软组织损伤的胫骨中远端骨折 16 例行经后外侧入路、胫骨后置钢板内固定治疗。评价临床与影像结果。［结果］ 16 例患者均顺利完成手术，术中无血管、神经损伤等并发症。切口均Ⅰ期愈合，无严重的关节肿胀、感染、血栓等早期并发症。随访 （14.16±5.21） 个月，恢复完全负重活动时间 （21.33±3.26） 周。末次随访时 VAS 评分较术后 3 个月显著降低 （P<0.05），而 AOFAS 评分、踝关节 ROM 显著增加 （P<0.05）。影像骨折复位质量，优 13 例，可 3 例，解剖复位率 81.25%， 影像骨折愈合时间 5~7 个月。［结论］后侧入路、后置钢板内固定是治疗前侧软组织损伤的胫骨中远端骨折的一种可靠选择和有效方法。

Abstract:

[Objective] To evaluate the clinical outcomes of posterior plate placement for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury. [Methods] From July 2014 to June 2021, a total of 16 patients received posterior plate place- ment for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury. [Results] All the 16 patients had opera- tion performed successfully without complications, such as neurovascular injuries, and got incisions healed well without early complica- tions, such as severe joint swelling, infection and thrombosis. All the patients were followed up for (14.16±5.21) months, with time to return to full weight-bearing activities of (21.33±3.26) weeks. The VAS score significantly decreased (P<0.05) , while AOFAS score and ankle range of motion (ROM) significantly increased at the latest follow-up compared with those 3 months after surgery (P<0.05) . Radiographical- ly, fracture reduction was marked as excellent in 13 cases, fair in 3 cases, and poor in 0 case with anatomical reduction rate of 81.25%. In addition, fracture healing achieved in all of them from 5 to 7 months postoperatively. [Conclusion] This posterior plate placement is a reli- able and effective method for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury.