| 胫骨近端骨折T入路术式对膝关节功能影响的随机对照试验 |
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投稿时间：2007-09-03
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| 作者 | Author | 单位 | Address | E-Mail |
| 彭伟雄 |
PENG Wei-xiong |
广州医学院荔湾医院骨科，广东 广州 510170 |
Department of Orthopaedics,Liwan Hospital of Guangzhou Medical College,Guangzhou 510170,Guangdong,China |
pengweixiong1966@126.com |
| 张志 |
ZHANG Zhi |
广州医学院荔湾医院骨科，广东 广州 510170 |
Department of Orthopaedics,Liwan Hospital of Guangzhou Medical College,Guangzhou 510170,Guangdong,China |
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| 梁洁红 |
Liang Jie-hong |
广州医学院荔湾医院骨科，广东 广州 510170 |
Department of Orthopaedics,Liwan Hospital of Guangzhou Medical College,Guangzhou 510170,Guangdong,China |
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| 期刊信息：《中国骨伤》2008年，第21卷，第4期，第264-266页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：探讨T入路术式治疗胫骨近端骨折的临床价值。
方法：113例胫骨近端骨折被随机分成2组：A组纵向弧形或S形等传统术式组62例，按Schatzker分类法：Ⅱ～Ⅵ型分别为25,10,16,6和5例；B组膝前髌骨下T形切口术式组共51例，Ⅱ～Ⅵ型分别为21,8,13,5和4例。术后通过SPSS 10.0数据处理软件比较两组手术时间、手术的出血量、住院时间、骨折临床愈合时间(下地时间)、骨折骨性愈合时间、并发症和膝关节功能恢复情况。
结果：A组随访60例，时间12～24个月，平均(16.42±1.22)个月；B组随访50例，时间12～24个月，平均(16.50±1.52)个月。①手术时间：B组比A组平均手术时间长，差异有统计学意义(P <0.01).②手术出血量：两组差异无统计学意义。③住院时间：两组差异无统计学意义。④骨折临床愈合时间(下地时间):B组下地活动时间短于A组(P<0.01).⑤骨折骨性愈合时间：B组骨性愈合快(P<0.01).⑥膝关节功能：按Rasmussen膝关节评分标准进行功能评分，术后6个月骨折愈合，8个月功能情况良好，Rasmussen膝关节功能评分为优，B组膝关节功能恢复优于A组(P<0.01).⑦术后并发症：A组关节粘连8例，关节僵硬3例，创伤性关节炎3例；B组关节粘连2例，创伤性关节炎1例，两组比较，B组并发症少于A组(P<0.05).
结论：膝前髌骨下T形切口术式内固定与纵向弧形、S形等传统术式比较有如下优点：术后瘢痕小，骨折临床愈合和骨性愈合时间短，关节活动功能恢复快，术后并发症少。 |
| 【关键词】胫骨骨折 外科手术 膝关节 随机对照试验 |
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| The randomized controlled trial of influences of T shape approach on the function of knee joint in the treatment of proximal tibial fractures |
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ABSTRACT
Objective: To investigate the clinical value of T shape approach in the treatment of proximal tibial fractures.
Methods: One handrend and thirteen patients of proximal tibial fractures were randomly divided into two groups. Group A:62 cases underwent the traditional exposure approach. According to Schatzker classification,the cases of Ⅱto Ⅵ type was 25,10,16,6,5 respectively. Group B:51 cases underwent T shape approach ahead of knee joint,the cases of Ⅱto Ⅵ type was 21,8,13,5,4 respectively. All data were analyzed by SPSS 10.0 to compare operation time,blood loss,duration of hospitalization,healing time,the time of osseous union and complications after operation.
Results: Sixty patients in group A and 50 patients in group B were followed-up from 12 to 24 months. ①Operation time:group B was longer than A(P<0.01).②Mean blood loss and duration of hospitalization was the same .③Clinical healing time:group B was shorter. ④Mean time of osseous union:group B was shorter. ⑤Function of knee:group B was better than group A. ⑥Complication:group B was less than group A.
Conclusion: As compared with traditional exposure approach,T shape approach of knee joint had advantages of small scar,fewer complications,faster union of fracture and earlier recovery of joint function. The approach is valuable for the treatment of proximal tibial fractures. |
| KEY WORDS Tibial fractures Surgical procedures,operative Knee joint Randomized controlled trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 彭伟雄,张志,梁洁红.胫骨近端骨折T入路术式对膝关节功能影响的随机对照试验[J].中国骨伤,2008,21(4):264~266 |
| 英文格式: | PENG Wei-xiong,ZHANG Zhi,Liang Jie-hong.The randomized controlled trial of influences of T shape approach on the function of knee joint in the treatment of proximal tibial fractures[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(4):264~266 |
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