锁定钢板与非锁定钢板治疗胫骨远端骨折哪个更好？

Are locking plates better than non-locking plates for treating distal tibial fractures?

机构信息

Foot and Ankle Unit, Instituto Traumatológico Teodoro Gebauer, Santiago, Chile.

Foot and Ankle Unit, Instituto Traumatológico Teodoro Gebauer, Santiago, Chile; Foot and Ankle Unit, Hospital Clínico Universidad de Chile, Santiago, Chile.

出版信息

Foot Ankle Surg. 2014 Jun;20(2):115-9. doi: 10.1016/j.fas.2013.12.004. Epub 2014 Jan 3.

DOI:10.1016/j.fas.2013.12.004

PMID:24796830

Abstract

BACKGROUND

Locking and non-locking plates has been used for distal tibia fracture osteosynthesis. Sufficient evidence to favor one implant over the other is lacking in the current literature. Our aim is to compare them in terms of fracture healing, alignment, functional outcome, complications.

METHODS

Sixty-eight patients operated on using a percutaneous plate were retrospectively reviewed. They were divided into two groups: in group 1 (28 patients) a 4.5mm narrow conventional dynamic compression plate (DCP) was used. In group 2 (40 patients) a titanium locked compression plate (LCP) was used.

RESULTS

Mean time to union was 16.2 and 15.4 weeks for group 1 and 2, respectively (p=0.618). 11 patients (39.3%) in group 1 and 4 patients (10%) in group 2 showed malalignment (p=0.016). AOFAS scores at follow up were 89 and 88 in groups 1 and 2, respectively. Implant removal was necessary in 9 cases (32.1%) and 4 cases (10%) in group 1 and group 2, respectively (p=0.042). Three patients (10.7%) in group 1 and three patients (7.5%) in group 2 had an infection.

CONCLUSIONS

Both plating systems have similar results in terms of time to union, infection, and AOFAS scores. The LCP seems superior with respect to alignment and the need for implant removal.

摘要

背景

锁定钢板和非锁定钢板已被用于胫骨远端骨折的内固定。目前的文献中缺乏一种植入物优于另一种植入物的充分证据。我们的目的是比较它们在骨折愈合、对线、功能结果和并发症方面的情况。

方法

回顾性分析了 68 例经皮钢板手术的患者。他们被分为两组：组 1（28 例）使用 4.5mm 窄常规动力加压钢板（DCP），组 2（40 例）使用钛锁定加压钢板（LCP）。

结果

组 1 和组 2 的平均愈合时间分别为 16.2 周和 15.4 周（p=0.618）。组 1 中有 11 例（39.3%）和组 2 中有 4 例（10%）出现对线不良（p=0.016）。组 1 和组 2 的 AOFAS 评分分别为 89 和 88。组 1 中有 9 例（32.1%）和组 2 中有 4 例（10%）需要取出内固定物（p=0.042）。组 1 中有 3 例（10.7%）和组 2 中有 3 例（7.5%）发生感染。