两种固定方法治疗闭合性胫骨远端骨折疗效比较.docVIP

两种固定方法治疗闭合性胫骨远端骨折疗效比较 　【摘要】 ［目的］总结分析胫骨远端外侧解剖钢板与苜蓿草钢板两种内固定治疗闭合性胫骨远端骨折的临床疗效。［方法］回顾性调查本院1999年5月-2008年5月手术治疗且获随访的85例闭合性胫骨远端骨折患者的资料,其中胫骨远端外侧解剖钢板固定组43例,苜蓿草钢板固定组42例,分析比较两者的治疗效果及优缺点，统计学分析手术时间、骨折愈合时间采用t检验,术后优良率、并发症发生率采用x2检验,Plt;0.05认为有统计学意义。［结果］全部病例随访6～96个月,平均48个月。平均手术时间、骨折愈合时间,两组比较无统计学意义；并发症的发生率苜蓿草钢板组高于胫骨远端外侧解剖钢板组，有显著性差异，术后优良率胫骨远端外侧解剖钢板组高于苜蓿草钢板组，有显著性差异。［结论］胫骨远端解剖钢板在闭合性胫骨远端骨折内固定中的疗效优于苜蓿草钢板内固定,具有并发症少、踝关节功能恢复好的优点。 【关键词】 胫骨； 闭合性骨折； 钢板； 固定 Abstract：［Objective］To compare the effects of anatomical lateral distal tibial plate and clover plate fixation for the treatment of closed distal tibial fracture.［Method］A retrospective survey was analyzed in our hospital from May 1999-May 2008.A total of 85 cases of closed distal tibial fracture were followed up. Fortythree were fixed by the lateral distal tibial anatomy plate and 42 cases by alfalfa grass plate .The clinical effects were analyzed and compared by operative time and fracture healing time. T test and x2 test were used for statistical analysis. Plt;0.05 was considered significant difference.［Result］All patients were followed up for 6 to 96 months, with an average of 48 months. There was no significant difference in operating time and bone healing time between the two groups. However, the complication incidence in the clover plate group was higher than that of the lateral distal tibial anatomical plate group.The good to excellent results in the lateral distal tibial anatomical plate group was in 88.37% higher than clover plate group(76.19%). There was significant difference.［Conclusion］The distal tibial anatomical plate for the treatment of closed distal tibial fracture is more effective than clover plate.There were fewer complications and good functional recovery for the ankle joint. Key words：tibial plate fixation 胫腓骨是长管状骨中最常发生骨折的部位。胫骨由于部位的关系，易遭受直接暴力打击，发生骨折。创伤面积大、骨折粉碎、污染严重、皮肤及软组织往往遭受严重挫灭伤，用什么方法处理最好，一直是骨折治疗中争议的问题［1］。胫骨远端骨折占四肢骨折的3.77%。由于其解剖特征限制了髓内固定系统的应用，外固定器固定既有针道感染问题又严重影响踝关节的功能，钢板固定成为治疗胫骨远端骨折的金标准［2］。回顾性调查本院1999年5月～2008年5月以