Affiliated Mindong Hospital of Fujian Medical University
2018Natural Science Foundation of Fujian Province (2018J01221)
[目的] 探讨应用自行研发的下肢骨折牵引复位装置微创治疗胫骨平台三柱骨折的临床疗效。 [方法] 回顾性分析2018年05月至 2021年1月收治的 30例胫骨平台骨折三柱患者资料，按治疗方法不同分为传统组和新型组，两组均为15例。传统组采用传统人力牵引的方法切开复位骨折。新型组采用下肢骨折牵引复位装置辅助复位骨折。两组均采用双钢板固定骨折。比较两组患者的手术时间，骨折复位时间，术中出血量，术后1周、术后1个月、12个月膝关节最大主动活动度，手术并发症及骨折愈合情况等。[结果] 新型组、传统组患者的手术时间分别为157.86±26.74min和203.93±60.81min，骨折复位时间分别为61.73±9.96min和75.33±16.55min，术中出血量分别为158.66±68.33ml和258.66±126.14ml，术后1周膝关节最大主动活动度分别为96.86±13.94度和78.13±15.09度；术后1个月膝关节最大主动活动度分别为115.73±14.50度和95.20±9.72度。以上两组的各种数据差异有统计学意义（P＜0.05）。 [结论] 下肢骨折牵引复位装置安全、有效，可应用于仰卧、侧卧、俯卧等体位,可以提高手术效率和微创效果，加快患者术后功能康复。
[Objective]To explore the clinical effect of minimally invasive treatment on tibial plateau three columns fractures adopting self developed traction reduction device on lower limb fracture.[Methods] A retrospective study was conducted on 30 patients with tibial plateau three columns fractures from May 2018 to January 2021. According the difference of treatment,the patients were divided into traditional group(15cases) and new group(15cases).The traditional group was adopted traditional artificial traction to achieve open reduction of fracture .The new group was adopted lower limb traction reduction device to assist achieving reduction of fracture. Two groups achieved internal fixation of fracture with double plates. The Surgical complications and fractures union conditions were analysed.The mean numbers of the targets as follow between the two groups were compared:operation time, fracture reduction time , intraoperative hemorrhage volume, maximum active extension–flexion degrees of knee joint at one week ,one and 12 months post-operatively.[Results] The mean operation time of the new group and traditional group was respectively 157.86±26.74min and 203.93±60.81min.The mean fracture reduction time of the new group and traditional group was respectively 61.73±9.96min and 75.33±16.55min. The mean intra-operative blood losses of the new group and traditional group was respectively 158.66±68.33mland 258.66±126.14ml. The maximum active extension–flexion degrees of knee joint at one week post-operatively of the new group and traditional group was respectively 96.86°±13.94°and 78.13°±15.09°，which at one month post-operatively of the two groups was115.73°±14.50°and 95.20±9.72°.The differences of the means above between the two groups were statistically significant (P＜0.05).[Conclusion] The traction reduction device on lower limb fracture is safe and effective to application,can be applied in supine, lateral and prone positions,improve operation efficiency and minimally invasive effect, rapidly recovers the function of knee.