Dai Jia-Ping, Yan Ying-Qi, Yu Ye-Feng, Zhou Xiao
Department of Orthopaedics, the Second Hospital of Jioxing, Jiaxing 314000, Zhejiang, China.
Zhongguo Gu Shang. 2009 May;22(5):361-3.
Evaluation of two different methods of treatment of distal tibial fractures of the clinical indications, complications and efficacy.
Forty-five cases of closed distal tibial fractures were assigned to two groups, 25 cases in group A included 18 males and 7 females, according to the AO/ASIF classification: 4 cases of type A, 14 cases of B, 7 cases of C, open reduction and anatomic plate fixation were used. Twenty cases in group B included 12 males and 8 females, 5 of type A, 9 of B, 6 of C, minimally invasive percutaneous locking compression plate osteosynthesis were used. Observed on the postoperative pain, skin necrosis of the incision, the incidence of deep infection and other complications, as well as the healing of fractures, ankle motor function for comparative study.
All patients were followed up 10 to 15 months, according to the visual analogue scale (VAS) score, group A were moderate to severe in, group B were mild to moderate between. Bone healing time: group A averaged (16.0+/-4.2) weeks, group B averaged (13.0+/-3.2) weeks, the difference was significant (P<0.01). Postoperative complications of group A was more than that of group B (P<0.05), there were significant differences. Ankle function in accordance with the assessment criteria Kofoed, the good and excellent rate of group B was higher than that of group A (P<0.05), there were significant differences.
Minimally invasive percutaneous locking compression plate osteosynthesis compared open reduction and anatomic plate fixation for distal tibial fractures with less trauma surgery, bone blood supply to the affected small, fracture healing faster, less complications, and ankle function better advantage of. It is consistent with the biomechanics of internal fixation, and is the treatment of tibial fractures ideal method.
评价两种不同治疗方法对胫骨远端骨折的临床适应证、并发症及疗效。
将45例闭合性胫骨远端骨折患者分为两组,A组25例,其中男18例,女7例,按AO/ASIF分类:A型4例,B型14例,C型7例,采用切开复位解剖钢板内固定。B组20例,其中男12例,女8例,A型5例,B型9例,C型6例,采用微创经皮锁定加压钢板接骨术。观察术后疼痛、切口皮肤坏死、深部感染等并发症的发生率,以及骨折愈合情况、踝关节运动功能进行对比研究。
所有患者均随访10~15个月,根据视觉模拟评分法(VAS)评分,A组为中度至重度,B组为轻度至中度。骨折愈合时间:A组平均(16.0±4.2)周,B组平均(13.0±3.2)周,差异有统计学意义(P<0.01)。A组术后并发症多于B组(P<0.05),差异有统计学意义。按照Kofoed评估标准评价踝关节功能,B组优良率高于A组(P<0.05),差异有统计学意义。
微创经皮锁定加压钢板接骨术治疗胫骨远端骨折较切开复位解剖钢板内固定具有手术创伤小、对患骨血供影响小、骨折愈合快、并发症少、踝关节功能恢复好的优点。它符合内固定生物力学要求,是治疗胫骨远端骨折的理想方法。