|摘要||目的 比较单臂外固定架和锁定加压钛板固定胫骨远端骨折的效果.方法 对2001年1月至2007年1月分别采用外固定架治疗和锁定钛板(LCP)治疗的胫骨远端骨折并获得随访的51例患者的病例资料进行总结,记录固定时间和骨折愈合时间,并按照美国骨科协会足踝外科分会(AOFAS)的标准评价踝关节功能,比较两组的治疗效果. 结果 外固定架组24例获得随访,骨折愈合时间120～276止平均160 d,按照AOFAS标准进行评分:优11例,良8例,可4例,差1例,优良率79.1%,并发症发生率12.5%;LCP组27例获得随访,骨折愈合时间95～184 d,平均143 d,按照AOFAS标准进行评分:优20例,良4例,可3例,优良率88.8%,并发症发生率11.0%,经统计学处理骨折愈合时间两组差异有统计学意义(t=2.561,P=0.014),并发症发生率和功能优良率差异无统计学意义(P＞0.05). 结论 外固定架和锁定钛板都是治疗胫骨远端骨折常用的有效固定方式,关键是遵循微创原则.实现胫骨骨折局部复位,骨缺损处植骨,胫骨支撑固定和腓骨骨折的复位固定,采取上述两种同定方式均可取得良好效果.
Objective To compare the treatment effeets of unilateral external fixators and locking compression plates(LCP)in treatment of distal tibial fractures. Methods From January 2001 to January 2007.5 1 patients with distal tibial fractures were treated surgically in our department.Twenty-four cases of them were fixed with unilateral external fixator,and 27 with LCE The clinical data of all the patients were reviewed,and the patients were followed up periodically after operation.,Their procedure of surgery,time of fracture healing,complication rate,and functional recovery rate were analyzed statistically. Results According to AO classification,there were 12 cases of type A,7 type B and 5 type C in external fixation group,and 20 cases of type A.5 type B and 2 type C in LCP fixation group.The mean clinical fracture union time for patients with external fixation Was 160(120 to 276)days,and 143(95 to 184)days for patients with LCP fixation.The complication rate for external fixator group was 12.5%.including 2 cases of deep infection and 1 case of malunion.It was 11%for LCP fixation group.including 2 cases of wound dehiscence and 1 case of deep infeetion. The functional recovery evaluation with AOFAS score system showed 79% of the cases in external fixation group and 88%in LCP fixation group obtained good to excellent results.Statistical analysis with independent samples t test showed significant difference(P＜0.05)in time of clinical fracture union,but no significant difference(P＞0.05)in complication rate and good to excellent functional recovery rate. Conclusion Unflateral external flxator and LCP are both effective methods for fixation of distal tibial fractures.|