论文部分内容阅读
目的:比较膝内外侧双切口与膝前正中直切口双钢板内固定术对复杂胫骨平台骨折患者膝关节功能的影响。方法:选取中国医科大学附属盛京医院2016年1月至2018年3月收治的行双钢板内固定术治疗的复杂胫骨平台骨折患者94例，采用随机数字表法分为对照组、观察组各47例，对照组给予膝前正中直切口，观察组给予膝内外侧双切口。比较两组患者围术期相关指标、胫骨平台后倾角、内翻角及膝关节功能评分的差异。结果:两组术中出血量差异无统计学意义(n P>0.05)；观察组手术时间[(84.35±11.85)min]长于对照组[(62.14±10.05)min]，治疗费用[(3.28±0.61)万元]多于对照组[(2.08±0.58)万元](n t＝9.80、9.12，均n P<0.01)。观察组住院天数、开始负重时间、骨折愈合时间分别为(6.78±2.17)d、(44.76±9.33)d、(3.57±1.04)个月，均短于对照组的(10.24±2.25)d、(55.09±10.25)d、(5.57±1.37)个月(n t＝7.59、5.11、7.97，均n P0.05)；对照组术后12个月胫骨平台后倾角、内翻角较术后6个月均显著提高(均n P0.05)；观察组术后12个月胫骨平台后倾角[(6.49±1.14)°]、内翻角[(85.17±2.70)°]均较对照组[(8.05±1.55)°、(91.35±2.88)°]显著降低(n t＝5.56、10.73，均n P0.05)；观察组术后6、12个月膝关节Rasmussen和Harris量表评分均较对照组明显提高(均n P0.05). The operation time of the observation group[(84.35±11.85)min]was longer than that of the control group[(62.14±10.05)min], the treatment cost of the observation group[(3.28±0.61)ten thousand CNY]was more than that of the control group[(2.08±0.58)ten thousand CNY](n t=9.80, 9.12, all n P<0.01). The days of hospitalization, the time of loading and the time of fracture healing in the observation group were (6.78±2.17)d, (44.76±9.33)d, (3.57±1.04)months, which were shorter than those in the control group[(10.24±2.25)d, (55.09±10.25)d, (5.57±1.37)months](n t=7.59, 5.11, 7.97, all n P0.05). In the control group, the posterior inclination angle and varus angle of the tibial plateau were significantly increased at 12 months after operation compared with 6 months after operation(alln P0.05). At 12 months after operation, the tibial plateau caster angle[(6.49±1.14)°]and the varus angle[(85.17±2.70)°] in the observation group were significantly lower than those in the control group[(8.05±1.55)° and (91.35±2.88)°](n t=5.56, 10.73, all n P0.05). The results of Rasmussen scale and Harris scale in the study group were significantly higher than those in the control group(alln P<0.01).n Conclusion:Compared with the knees straight incision, although knee inside and outside double incision double plate fixation treatment for patients with complex tibial plateau fractures can lead to increased operation time, high cost of treatment, but can shorten in-hospital time, promote the fracture healing after surgery, promote the recovery of the original anatomical structures, which can effectively improve the function of knee joint, thus is worthy of clinical application.