刘雄业 王荣生 石裕明

[摘要]目的 探討锁定钢板加植骨固定联合早期功能锻炼应用于胫骨平台骨折患者治疗的临床效果。方法 选取2014年1月～2017年3月我院收治的98例胫骨平台骨折患者作为研究对象，均给予锁定钢板加植骨固定联合早期功能锻炼，观察术后并发症、完全负重时间、骨折愈合时间、膝关节评分标准（HSS）评分情况，对术后不同时间的平台后倾角（PA）、胫骨平台内翻角（TPA）度数进行比较。结果 本组98例患者不存在严重皮肤坏死，且未发生钢板松动、伤口感染等情况。随访1年，患者完全负重时间为90～110 d，平均（98.69±3.69）d；骨折愈合时间87～112 d，平均（96.98±3.32）d。术后3个月的HSS评分为（72.12±10.16）分，术后6个月为（77.45±9.81）分，术后12个月为（84.65±11.20）分。术后12个月优良率为95.92%，明显高于术后3、6个月的76.53%、83.67%，差异有统计学意义（P<0.05）。结论 锁定钢板加植骨固定联合早期功能锻炼在胫骨平台骨折患者治疗中有显著效果，可有效促进患者骨折骨关节功能恢复，无并发症，对提高术后患者的生活质量具有积极意义。

[关键词]锁定钢板加植骨固定；早期功能锻炼；胫骨平台骨折

[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-4721（2018）8（b）-0102-04

Application of locking plate and bone graft fixation combined with early functional exercise in the treatment of patients with tibial plateau fractures

LIU Xiong-ye WANG Rong-sheng SHI Yu-ming

Department of Orthopaedics， Xinyi People′s Hospital， Guangdong Province， Xinyi 525300， China

[Abstract] Objective To investigate the clinical effect of locking plate and bone graft fixation combined with early functional exercise in the treatment of patients with tibial plateau fractures. Methods A total of 98 patients with tibial plateau fractures treated in our hospital from January 2014 to March 2017 were selected as study subjects. They were all provided with locking plate and bone graft fixation combined with early functional exercise in order to observe postoperative complications， complete loading time， healing time of bone fracture， knee joint scoring standard （HSS） scores. Meanwhile， the degrees of PA and TPA at different time after surgery were compared. Results Among 98 patients， there was no severe skin necrosis， loosening of steel plates or wound infection. After one year of follow-up， the patient′s complete loading time was 90-110 d， average （98.69±3.69） d. The fracture healing time was 87-112 d， average （96.98±3.32） d. The HSS scores after 3， 6 and 12 months operation were （72.12±10.16） points， （77.45±9.81） points， and （84.65±11.20） points in turn. The excellent and good rate was 95.92% after 12 months operation， significantly higher than 76.53% and 83.67% after 3 and 6 months operation respectively， with statistical significance （P<0.05）. Conclusion Locking plate and bone graft fixation combined with early functional exercise have significant effect in the treatment of patients with tibial plateau fractures， which can effectively promote fracture and joint function recovery without complications， and paly positive significance for the improvement of postoperative quality of life.

[Key words] Locking plate and bone graft fixation； Early functional exercise； Tibial plateau fracture

胫骨平台骨折属于骨科常见伤情，胫骨与股骨是膝关节承受重力与运动的根本，若发生骨折，则会直接影响到膝关节原来的结构，致使膝关节出现功能障碍[1-2]。该种骨折发生常见原因包括交通事故、高处坠落等，随着交通日益发展，骨折患者数量明显增多[3]，对此种骨折，临床往往给予手术治疗，尽管手术可取得显著效果，但术后可能还会发生膝关节功能障碍，不利于生活质量恢复。本研究采用锁定钢板加植骨固定联合早期功能锻炼应用于胫骨平台骨折患者治疗，取得显著效果。本研究选我院收治的胫骨平台骨折患者98例作为研究对象，详细报道如下。……