[1]胡栢均,高大伟,吴宇峰,等.双反牵引架辅助微创治疗难治性胫骨平台骨折临床价值研究*[J].陕西医学杂志,2020,49(9):1090-1093.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.009]
　HU Baijun,GAO Dawei,WU Yufeng,et al.Clinical value of double reverse traction frame assisted minimally invasive treatment of refractory tibial plateau fracture[J].,2020,49(9):1090-1093.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.009]
点击复制

双反牵引架辅助微创治疗难治性胫骨平台骨折临床价值研究*

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年9期
页码:
1090-1093
栏目:
临床研究
出版日期:
2020-09-01

文章信息/Info

Title:
Clinical value of double reverse traction frame assisted minimally invasive treatment of refractory tibial plateau fracture
作者:
胡栢均; 高大伟; 吴宇峰; 林志炯; 陈 亮; 万 明
广东省中山市中医院骨科(中山 528400)
Author(s):
HU Baijun; GAO Dawei; WU Yufeng; et al.
Department of Orthopedics,Zhongshan Hospital of Traditional Chinese Medicine,Guangdong Province(Zhongshan 528400)
关键词:
难治性胫骨平台骨折;  双反牵引;  微创;  膝关节屈伸功能;  骨折愈合;  切口并发症
Keywords:
Refractory tibial plateau fracture;  Double reverse traction;  Minimally invasive;  Flexion and extension function of knee joint;  Fracture Healing;  Incision complication
分类号:
R683.42
DOI:
DOI:10.3969/j.issn.1000-7377.2020.09.009
文献标志码:
A
摘要:
目的:探讨双反牵引架辅助微创治疗难治性胫骨平台骨折(TPF)的临床疗效。方法:纳入63例Schatzker Ⅴ型和Ⅵ型TPF患者,根据手术方式不同分为对照组(30例)和观察组(33例)。对照组采用传统切开手术,观察组采用双反牵引架辅助微创手术。比较两组手术时间、术中出血量、术后恢复情况、术后膝关节屈伸功能情况、手术切口并发症发生情况。结果:观察组手术时间、术中出血量均低于对照组(P<0.05); 观察组术后双下肢长度差、骨折成角均小于对照组(P<0.05); 观察组术后负重时间、骨折愈合时间均较对照组短(P<0.05); 术后1周、3个月、6个月膝关节屈伸功能活动度均大于对照组(P<0.05); 观察组术后切口并发症发生率低于对照组(P<0.05)。结论:双反牵引架辅助微创治疗难治性TPF效果好,可有效改善膝关节屈伸功能,减少手术时间及术中出血量,缩短骨折愈合时间,且术后不良切口并发症少。
Abstract:
Objective:To explore the clinical effect of double reverse traction frame assisted minimally invasive treatment of refractory tibial plateau fracture(TPF).Methods:63 patients with Schatzker type Ⅴ and type Ⅵ TPF were included and divided into control group(30 cases)and observation group(33 cases).The control group was treated with traditional operation,and the observation group was treated with double reverse traction frame assisted minimally invasive surgery.The operation time,intraoperative hemorrhage volume,postoperative recovery,flexion and extension function of knee joint and complications of incision were compared between the two groups.Results:The operation time and intraoperative hemorrhage volume in the observation group were lower than those in the control group(P<0.05).The length difference of lower limbs and angle of fracture in the observation group were lower than those in the control group(P<0.05).The weight-bearing time and fracture healing time after surgery in the observation group were shorter than those in the control group(P<0.05).The flexion and extension function activity of knee joint 1 week,3 months and 6 months after surgery in the observation group were higher than that in the control group(P<0.05).The incidence of postoperative incision complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Double reverse traction frame assisted minimally invasive treatment of refractory TPF has good effect,can effectively improve the knee joint flexion and extension function,reduce the operation time and intraoperative hemorrhage volume,shorten the time of fracture healing,and has less postoperative adverse incision complications.

参考文献/References:

[1] 王立山.单纯外侧锁定钢板固定与双切口双钢板固定治疗胫骨平台双髁骨折64例临床效果对比分析[J].陕西医学杂志,2017,46(9):1213-1214.
[2] 郑占乐,张 飞,张英泽,等.双向牵引闭合复位微创治疗胫骨平台骨折的初步临床应用[J].河北医科大学学报,2015,36(4):491-492.
[3] 王 娟,李 升,张英泽,等.应用四肢长骨骨折快速复位器治疗股骨骨折[J].河北医科大学学报,2014,35(2):220-221.
[4] 陈 伟,魏 宁,张英泽,等.顺势双反牵引复位和牵引床复位对手术治疗老年股骨转子间骨折疗效的影响[J].中华创伤杂志,2017,33(4):332-337.
[5] 鲍飞龙,刘 涛,亢世杰,等.传统切开复位内固定与双反牵引微创复位经皮内固定治疗胫骨平台骨折的临床疗效比较[J].中华创伤骨科杂志,2017,19(10):854-860.
[6] 邹 剑,范鑫斌,张长青.胫骨远端骨折:经皮钢板内固定优于切开复位内固定吗?[J].中华创伤骨科杂志,2009,11(9):821-824.
[7] 郭清皓,蔡 钧,杨世疆,等.壮筋续骨汤联合锁定加压钢板内固定治疗胫骨平台骨折的临床效果[J].陕西中医,2016,37(7):782-783.
[8] 郑 勇,王 剑,刘先齐,等.双反牵引微创复位植骨内固定治疗Schatzker Ⅱ-Ⅳ型胫骨平台骨折的应用[J].检验医学与临床,2019,16(6):796-798.
[9] 郑龙坡.顺势复位治疗胫骨平台骨折的临床研究[J].中华老年骨科与康复电子杂志,2018,4(3):163-167.
[10] 徐青镭,李 飞,韩国一,等.胫骨平台骨折合并膝关节脱位的早期评估与分期全修复治疗[J].中华创伤骨科杂志,2016,18(10):845-850.
[11] 闵 理,屠重棋,段 宏,等.联合入路双或三钢板固定治疗Schatzker Ⅴ型及Ⅵ型胫骨平台骨折[J].中华创伤骨科杂志,2013,15(10):902-905.
[12] 常恒瑞,于沂阳,邢 欣,等.顺势牵引微创治疗胫骨平台骨折[J].中华关节外科杂志:电子版,2017,11(1):24-28.
[13] 王鹏斌,王立松,苏秀君,等.后外侧入路与后内侧入路治疗胫骨平台后外侧骨折临床研究[J].陕西医学杂志,2019,48(4):499-501.
[14] 闫献雨,李程锦,褚青波,等.关节镜辅助治疗对胫骨平台骨折患者微循环与炎性应激的影响研究[J].陕西医学杂志,2017,46(3):310-312.
[15] 梁晶亮,雷 军,李智斌,等.膝关节内外侧双切口双钢板复位内固定术治疗复杂胫骨平台骨折41例[J].陕西医学杂志,2017,46(6):746-747.

备注/Memo

备注/Memo:
*广东省中山市社会公益科技研究专项立项项目(2018B1061)
更新日期/Last Update: 2020-09-02