Effect of double-incision double-plate internal fixation on the degree of healing,stability and bone metabolism of patients with tibial plateau fracture
Objective To observe the effect of double-incision double-plate internal fixation on the degree of healing,stability and bone metabolism of patients with tibial plateau fracture.Methods 68 patients with tibial plateau fracture were divided into a control group(unilateral plate internal fixation)and an experimental group(double-incision double-plate internal fixation)according to different surgical treatment plans,each with 34 cases.Patients in both groups were compared in terms of surgical indicators and healing status,clinical efficacy,occurrence of surgery-related complications,stability after fracture reduction[varus inclination and caster angle of the tibial plateau immediately after surgery,3 and 6 months after surgery],postoperative serum bone metabolic markers[osteocalcin(BGP),human calcitonin(hCT)and bone-specific alkaline phosphatase(BALP)].Results There was no statistically significant difference in operation time,total amount of intraoperative bleeding and incision length between the two groups(P>0.05).In the experimental group,the postoperative exercise time was(5.54±1.03)d,the weight-bearing time was(5.03±0.75)weeks and the fracture healing time was(11.04±1.78)weeks,which were significantly shorter than(9.65±2.48)d,(6.75±1.02)weeks and(14.89±2.20)weeks in the control group(P<0.05).At 3 and 6 months after surgery,the excellent and good recovery rates of knee function in the experimental group were 67.65%and 91.18%,which were higher than 38.24%and 70.59%in the control group(P<0.05).The complication rate of 8.82%in the experimental group was lower than 29.41%in the control group(P<0.05).At 3 and 6 months after surgery,there was no statistically significant difference in the varus inclination of the tibial plateau in the experimental group compared with immediately after surgery(P>0.05).The varus inclination of the tibial plateau of the control group increased significantly compared with immediately after surgery,and the control group was significantly larger than the experimental group(P<0.05).The caster angle of the tibial plateau in both groups increased significantly compared with immediately after surgery,and the control group was significantly larger than the experimental group(P<0.05).At 3 and 6 months after surgery,the serum levels of BGP,hCT and BALP in the experimental group were significantly higher than those in the control group(P<0.05).Conclusion The clinical effect of double-incision double-plate internal fixation for tibial plateau fracture is significantly better than unilateral plate internal fixation,which can accelerate the fracture healing of the patient,prevent or reduce the occurrence of postoperative complications,and is more biomechanically stable,which can promote bone metabolism and bone healing at the fracture site.
Double-incision double-plate internal fixationTibial plateau fractureDegree of healingStabilityBone metabolism
万方数据
维普
