Comparing Different Surgical Method of Complex Fractures of Tibial Plateau and Clinical Curative Effect Analysis
|Keywords||Tibial plateau fractures Double incision double steel plate Unilaterallocking plate Internal fixation with Treatment effect|
Objective: Explore double incision and double plate fixation unilateral locking plateinternal fixation with two methods of surgical treatment of complex tibial plateaufractures with the indication and clinical effect. Provide theoretical basis for choosing theappropriate clinical treatment.Methods: By using the method of retrospective analysis of yan ’an university hospitalorthopaedics in from January2008to May2008collected between68patients withcomplex tibial plateau fractures, respectively adopt double incision double steel plate andone locking plate internal fixation with two methods clinical data of postoperative andpreoperative radiation as a result, Use of double incision double steel plate for32cases,locking plate internal fixation treatment of36cases Falls of34cases of traffic accidentinjuries of26cases, other injuries account for8cases,37cases of left knee, right knee31cases.According to the Schatzker type points: type Ⅴ38cases,30cases Ⅵtype.Through outpatient follow-up visits and communications follow-up records, from theoperation time, intraoperative blood loss, hospitalization time, fracture healing time, fullweight bearing time, joint function recovery, complications occurrence of comparing twosurgical methods of assessment, and statistical analysis.Results: Locking plate and double steel group are operating under tourniquet, andintraoperative blood loss, no statistical difference. Locking plate group and double steelplate on the length of hospital stay and postoperative complications, there was nostatistically significant difference. Locking plate group on operation time and fracturehealing time is shorter than double steel plate group, locking plate group in full weightbearing time and postoperative knee function score1year (Song Yongjin curative effectevaluation standard) slightly higher than the double steel group. Two groups of patientswere not deep infection after surgery and weight after the loose screw and plate fracture, fracture nonunion or delayed union, no bone fascia compartment syndrome and deep veinthrombosis and other complications. To sum up, it shows that mechanics stabilityprovided by the two methods of internal fixation of similar.Conclusion:1. This study of double incision double steel plate internal fixationwith locking plate internal fixation treatment of complex tibial plateau fractures ofpreoperative, intraoperative, operative methods, postoperative clinical data comparison,suggests that both can obtain satisfactory clinical effect, each have their advantages anddisadvantages, each has its advantages and disadvantages2. The results show that the locking plate group on operation time and fracture healingtime is shorter than double steel group, with statistical significance. Locking plate groupin full weight bearing time and postoperative knee function score1year (Song Yongjincurative effect evaluation standard) is slightly higher than the double steel plate group,but there were no statistically significant difference (P> o.05).3. Complex tibial plateau fractures in choosing or locking plate internal fixationtreatment of double plate fixation, to fracture the anatomical repositioning, guarantee thestability of joint and a good matchup. Compression of the joint surface is raised to thewhole, to ensure the accuracy and completeness of the reset. Stem epiphyseal side shouldfully bone graft, bone defect prevent secondary reset lost. Sustained and stable internalfixation to ensure early functional exercise, recovery of motion. Early activity, on theearly healing of articular cartilage and effectively achieve the knee joint functionrecovery. The above is the key of the treatment of complex tibial plateau fractures.4. In a word, complex tibial plateau fractures in choosing or locking plate internalfixation treatment of double plate fixation, if there is a detailed preoperative evaluation,proper choice of operation time, reasonable surgical approaches, fracture anatomicalreduction, firm internal fixation, reasonable and sufficient bone graft, and postoperativeknee, correct function exercise, early after operation can get good clinical curative effect.Cue by comprehensive analysis of complex tibial plateau fractures treated by unilateral locking plate has a shorter operation time, small trauma, less and periosteum interface,powerful advantages of fixed, double incision double steel plate fixed treatment ofcomplex tibial plateau fractures with high stability, lower limbs after the good lines offorce, high knee functional recovery rate. The clinical treatment effect is satisfactory, it isworth in clinical application.