老年复杂过伸型胫骨平台骨折两种术式的疗效对比
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1.山西医科大学;2.吕梁市人民医院

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吕梁市重点研发项目


Comparison of two surgical methods for elderly patients with complex hyperextension tibial plateau fracture
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1..Shanxi Medical University;2.Lvliang People'3.'4.s Hospital

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Lvliang Key R&D Projects

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    摘要:

    [目的] 比较双切口双钢板与双切口三钢板治疗老年复杂过伸型胫骨平台骨折的临床疗效。[方法] 回顾性分析2017年4月至2023年4月期间在山西医科大学附属吕梁医院采用双钢板和三钢板内固定治疗老年复杂过伸型胫骨平台骨折80例患者的临床资料。依据术前医患沟通结果,40例采用双切口双钢板内固定(双钢板组),40采用双切口三钢板内固定(三钢板组),比较分析两组围手术期、随访及影像学资料。[结果] 两组患者均顺利完成手术,无严重并发症发生。双钢板组手术时间、术中出血量、术后引流量显著少于三钢板组,差异均有统计学意义(P<0.05);两组住院时间、功能锻炼时间、负重活动时间、膝关节功能优良率、术后并发症发生率等方面差异均无统计学意义(P>0.05)。术后6个月三钢板组膝关节HSS评分显著高于双钢板组,差异有统计学意义(P<0.05),而术后12个月两组患者膝关节HSS评分差异无统计学意义(P>0.05)。三钢板组术后1天和3天VAS评分显著高于双钢板组(P<0.05),差异有统计学意义,术后12天时两组VAS评分差异无统计学意义(P>0.05)。影像方面,拔管后复查内翻角和后倾角两组差异无统计学意义(P>0.05),术后半年复查三钢板组内翻叫和后倾角显著高于双钢板组,差异有统计学意义(P<0.05)。两组患者均骨折愈合,骨折愈合时间差异无统计学意义(P>0.05)。[结论]双切口三钢板内固定相比,双切口双钢板内固定具有手术时间短、术中出血量少、术后引流量少、对周围软组织损伤小的优点,由于病例数较少且缺乏远期随访结果,还需要更进一步观察研究。

    Abstract:

    [Objective] To compare the clinical efficacy of double-cut double-plate and double-cut triple-plate in the treatment of elderly complex hyperextension tibial plateau fracture.[Methods] The clinical data of 80 elderly patients with complex hyperextension tibial plateau fracture treated by double-plate and triple-plate internal fixation in Lvliang Hospital Affiliated to Shanxi Medical University from April 2017 to April 2023 were retrospectively analyzed. According to the results of preoperative doctor-patient communication,40 cases underwent internal fixation with double incision and double plate (double plate group), and 40 cases underwent internal fixation with double incision and three plate (three plate group). The perioperative period, follow-up and imaging data of the two groups were compared and analyzed. [Results] Both groups of patients successfully completed the operation without serious complications.The operative time, intraoperative blood loss and postoperative drainage volume in the double-plate group were significantly lower than those in the three-plate group, with statistical significance (P < 0.05).There were no significant differences in hospitalization time, functional exercise time, weight-bearing activity time, excellent and good rate of knee function, and postoperative complications between the two groups (P > 0.05).The knee HSS score in the three-plate group was significantly higher than that in the double-plate group at 6 months after surgery, with statistical significance (P < 0.05), but there was no statistical significance in the knee HSS score between the two groups at 12 months after surgery (P > 0.05).The VAS score of the three plate group was significantly higher than that of the double plate group at 1 and 3 days after surgery (P < 0.05), and the difference was statistically significant, but there was no statistically significant difference between the two groups at 12 days after surgery (P > 0.05).In terms of imaging, there was no significant difference between the two groups (P > 0.05) in introvert Angle and backward inclination after extubation, but the introvert call and backward inclination in the three-plate group were significantly higher than those in the double-plate group after half-year surgery, with statistical significance (P < 0.05).There was no significant difference in fracture healing time between the two groups (P > 0.05).[Conclusion] Compared with double-incision and three-plate internal fixation, double-incision and double-plate internal fixation has the advantages of shorter operation time, less intraoperative blood loss, less postoperative drainage flow, and less damage to the surrounding soft tissue. Due to the small number of cases and lack of long-term follow-up results, further observation and research are needed

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  • 收稿日期:2023-09-26
  • 最后修改日期:2023-11-25
  • 录用日期:2024-02-28
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