锁定加压钢板与外固定架治疗胫骨远端骨折的对比分析

刘强

【摘要】 目的 对比分析锁定加压钢板与外固定架治疗胫骨远端骨折的手术治疗效果， 从而为胫骨远端骨折的临床治疗提供进一步的指导依据。方法 应用锁定加压钢板治疗的30例胫骨远端骨折患者， 设立为锁定加压钢板组， 另选择同期行外固定架治疗的30例胫骨远端骨折患者设立为外固定架组， 比较两组的疗效， 以及手术时间、平均术中术后出血量、骨折愈合时间、术后随访期间并发症情况。结果 锁定加压钢板组的优良率90.0%， 外固定架组的优良率80.0%， 两组比较差异无统计学意义（P>0.05）。锁定加压钢板组的手术时间、平均术中术后出血量、骨折愈合时间与外固定架组比较， 差异无统计学意义（P>0.05）。锁定加压钢板组术后发生感染、骨折延迟愈合及畸形愈合等例数明显少于外固定架组， 两组比较差异有统计学意义（P<0.05）。结论 锁定加压钢板与外固定架治疗胫骨远端骨折疗效相似， 但锁定加压钢板的术后并发症少， 因此， 临床医生应根据患者骨折的具体情况选择合适的固定方式。

【关键词】 胫骨远端骨折；锁定加压钢板；外固定架

DOI：10.14163/j.cnki.11-5547/r.2016.08.002

Comparative analysis of locking compression plate and external fixator in the treatment of distal tibial fracture LIU Qiang. Department of Orthopedics， Beijing Longfu Hospital， 100010， China

【Abstract】 Objective To compare and analyze curative effects by locking compression plate and external fixator in the treatment of distal tibial fracture， in order to provide further guidance and reference for clinical treatment of distal tibial fracture. Methods There were 30 patients with distal tibial fracture receiving locking compression plate for treatment as locking compression plate group， and another 30 patients receiving external fixator for treatment at the same period as external fixator group. Curative effects， operation time， average intraoperative and postoperative bleeding volume， fracture healing time， postoperative complications during follow-up were compared between the two groups. Results The locking compression plate group had good rate as 90.0%， and the external fixator group had that as 80.0%. Their difference had no statistical significance （P>0.05）. There was no statistical significance in difference of operation time， average intraoperative and postoperative bleeding volume， and fracture healing time between the locking compression plate group and the external fixator group （P>0.05）. The locking compression plate group had obviously less cases with postoperative infection， delayed union， and malunion than the external fixator group， and their difference had statistical significance （P<0.05）. Conclusion Locking compression plate and external fixator provides similar curative effects in treating distal tibial fracture， while locking compression plate provides less postoperative complications. Therefore， specific choice should be made on the basis of fracture condition.

【Key words】 Distal tibial fracture； Locking compression plate； External fixator

胫骨远端骨折是指胫骨远端5 cm内的骨折[1]， 与四肢其他部位骨折相比损伤机制有其特殊性。因此， 充分认识胫骨远端骨折的临床特点， 选择合适的手术方法对于提高手术疗效， 减少术后并发症的发生具有重要的临床意义。本研究旨在对比分析锁定加压钢板（locking compression plate， LCP）内固定与外固定架治疗胫骨远端骨折的手术治疗效果， 从而为胫骨远端骨折的临床治疗提供进一步的指导依据。现报告如下。

1 资料与方法

1. 1 一般资料 将本院2010年1月～2012年1月应用锁定加压钢板治疗的30例胫骨远端骨折患者， 设立为锁定加压钢板组， 男18例， 女12例， 年龄20～64岁， 左侧13例， 右侧17例。受伤……