内外侧加压钢板法治疗胫骨远端骨折的比较前瞻性研究

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摘要

最常见的长骨骨折是胫骨骨折。解剖复位和刚性固定可由切开复位和钢板引起。评估和比较内侧和外侧锁定加压钢板治疗胫骨远端骨折的效果。该前瞻性临床研究于2019年11月22日至2020年11月12日在楠格哈尔大学和公共卫生医院招募了32例胫骨远端骨折患者。平均年龄34.57岁,闭合性骨折26例,开放性骨折6例。根据治疗方式将32例患者分为内侧钢板组(16例)和外侧钢板组(16例)。释放后,对他们进行了至少5个月的监测。采用Tinny和Wiss制定的临床评估标准评估功能结局。结果内侧钢板组2例,外侧钢板组2例出现不愈合。内侧钢板组浅表感染4例,深部感染2例,创面不愈合1例,裂开2例。3组2例浅表感染1例,深部感染1例,骨不连2例,分为优1、好7、一般8、差4级。侧镀组评分为优2分,良6分,一般7分,差1分。内侧钢板组踝关节背屈和足底屈的极限活动范围分别为18.2°和29.5°。外侧钢板组踝关节背屈为20°,足底屈为33.2°。最后,胫骨远端外侧平板是安全实用的,可以提供生物固定,避免软组织并发症。
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Comparative Prospective Study: Treatment of Distal Third Tibial Fracture through Medial and Lateral Compression Plate Methods
The most frequent fracture of a long bone is a tibial fracture. Anatomical reduction and rigid fixing may arise from open reduction and plating. To assess and contrast the outcomes of medial and lateral locking compression plates for fractures in the distal part of the tibia. 32 patients with distal tibial fractures were enrolled in the prospective clinical study from November 22, 2019, to November 12, 2020, at Nangarhar University and Public Health Hospital. With a mean age of 34.57 years, 26 closed fractures, and 6 open fractures. Based on the manner of therapy, 32 patients were split into two groups, with the medial plating group (16) included (16 patients) and the lateral plating group. After being released, they were monitored for at least 5 months. The clinical assessment criteria developed by Tinny and Wiss were used to evaluate the functional outcomes. Malunion arose in two cases of the medial plating group and two cases of the lateral plating group as a result.4 cases of superficial and 2 cases of deep infections, 1 nonunion, and 2 wound dehiscence were found in the medial plating group. There were two cases of superficial and one case of deep infection as well as two nonunion in the group3 cases that were classified as excellent-1, good-7, fair-8, and poor. In the lateral plating group, the scores were Excellent 2, good 6, fair 7, and poor 1 respectively. Ankle dorsiflexion and plantar flexion ultimate ranges of motion in the medial plating group were 18.2° and 29.5°, respectively. The end range of motion for the lateral plating group was 20° for ankle dorsiflexion and 33.2° for ankle plantar flexion. Finally, it is safe and practical to plat the distal tibia laterally, which can provide biological fixation and avoid soft tissue complications.
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