JOURNAL OF CLINICAL SURGERY ›› 2020, Vol. 28 ›› Issue (4): 326-330.doi: 10.3969/j.issn.1005-6483.2020.04.009

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Effect analysis of different fixation methods in the treatment of complex tibial plateau fracture

  

  1. Department of Orthopedics,the Fourth People's Hospital of Taizhou,Jiangsu,Taizhou 225300, China
  • Online:2020-04-20 Published:2020-04-20

Abstract: Objective To investigate the relationship between internal fixation of anatomical plate,DIDPIF and ULPIF and the recovery of patients with complex tibial plateau fractures,the infection rate of incision and the degree of motion of knee joint. Methods A total of 150 patients with complex tibial plateau fractures were selected to be treated in our hospital from January 2016 to January 2019.According to the random number table method,the patients were divided into anatomic plate fixation group,DIDPIF treatment group and ULPIF treatment group,with 50 patients in each group.The clinical curative effect,postoperative complications,knee joint function and the three groups of patients were observed. Results There was no significant difference in operative time [(95.43±15.16)vs(96.01±16.09)vs(95.99±15.19)] min,intraoperative blood loss [(281.55±52.07)vs(283.59±53.11)vs(282.66±53.04)] ml and incision length [(11.38±0.73)vs(10.97±0.44)vs(10.64±0.69)] cm among anatomic plate fixation group,DIDPIF treatment group and ULPIF treatment group(P>0.05).There were significant differences in weight-bearing time,healing time and knee joint exercise time among the three groups(P<0.05);Among them,the load time and healing time of ULPIF treatment group were significantly lower than that of DIDPIF treatment group (P<0.05),the time of knee joint exercise in the DIDPIF treatment group was significantly less than that in the ULPIF treatment group.After operation,3 months,12 months after operation of TPA and PA were significant different among the three groups(P<0.05),〖JP3〗while there was no significant difference between the DIDPIF treatment group and the ULPIF treatment group(P<0.05).There was no significant difference in HSS score and excellent and good rate between DIDPIF treatment group and ULPIF treatment group(P>0.05),but both of them were significantly higher than those of the anatomic internal fixation group(P<0.05).In terms of postoperative complications,there was no statistically significant difference between the DIDPIF treatment group and ULPIF treatment group,while both of them were significantly lower than anatomical plate internal fixation group(P<0.05). Conclusion The curative effect of unilateral locking plate internal fixation and double incision double plate internal fixation in the treatment of tibial plateau fracture is similar,both can obtain satisfactory fixation stability,better than anatomical plate internal fixation.In addition,the patient has a good lower limb strength line and a high recovery rate of knee joint function after recovery,but each has its advantages and disadvantages,so the operation method should be selected clinically according to the actual situation of the patient.

Key words: internal fixation of unilateral locking plate, double incision double plate internal fixation, internal fixation of anatomical plate, complex tibial plateau fracture, knee range of motion

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