陈泽

[摘要] 目的 探讨分期钢板内固定和一期减压外固定架固定治疗胫骨中段骨筋膜室综合征的效果。 方法 选取2018年8月至2020年8月于我院治疗的胫骨中段骨筋膜室综合征患者118例，随机分为对照组和研究组，每组各59例。对照组应用一期减压外固定架固定治疗，研究组应用分期钢板内固定治疗。比较两组患者的不良反应发生率、骨折愈合时间、膝关节活动度，HSS评分以及治疗效果。 结果 研究组愈合时间短于对照组，膝关节活动度和HSS评分优于对照组（P<0.05）;研究组不良反应发生率低于对照组（P<0.05），治疗效果优于对照组（P<0.05）。结论 胫骨中段骨筋膜室综合征患者应用分期钢板内固定治疗效果显著，可以减少不良反应发生率，提高膝关节功能和活动度，促进骨折愈合，提高治疗效果，值得临床推广和应用。

[关键词] 分期钢板内固定;一期减压外固定架;固定治疗;胫骨中段;骨筋膜室综合征

[中图分类号] R687.3          [文献标识码] A          [文章编号] 1673-9701（2021）32-0014-04

[Abstract] Objective To investigate the effect of staged internal fixation with steel plate and one-stage decompression and external fixation for the treatment of compartment syndrome of the middle tibia. Methods A total of 118 patients with middle tibial compartment syndrome treated in our hospital from August 2018 to August 2020 were selected and randomly divided into  control group and study group， with 59 cases in each group. The control group was treated with one-stage decompression and external fixation， and the study group was treated with staged steel plate internal fixation. The incidence of adverse reactions， fracture healing time， knee range of motion， HSS score， and treatment effects between the two groups was observed and compared. Results The healing time of the study group was shorter than that of the control group， and the knee range of motion and HSS score of the study group were better than those of the control group （P<0.05）. The incidence of adverse reactions in the study group was lower than that of the control group （P<0.05）. The treatment effect of the group was better than that of the control group （P<0.05）. Conclusion The staged plate internal fixation for patients with middle tibial compartment syndrome has a significant reatment effect， which can reduce the chance of adverse reactions， improve knee joint function and mobility， promote fracture healing， and improve the treatment effect. It is worthy of clinical promotion and application.

[Key words] Staged steel plate internal fixation; One-stage decompression and external fixation; Fixation treatment; Middle tibia; Compartment syndrome

骨科中常见的一种高能量骨折就是胫骨平台骨折，会影响膝关节的稳定性、完整性及协调性。治疗不当会导致关节僵硬、关节不稳和创伤性关节炎。骨筋膜室综合征指的是患者发生肢体创伤后，在特定的四肢骨筋膜间室中发生进行性血液循环障碍，导致骨筋膜室的神经肌肉缺血或坏死的一种综合征[1]。近几年，随着社会工业化的发展以及物理和交通的普及，高能量骨折患者不断增加。胫骨中段骨筋膜室综合征患者如果没有给予及時有效的治疗，会导致肌肉不可逆性坏死，肌肉挛缩，神经血管损伤，永久性功能丧失[2]。……