Analysis Of The Clinical Efficacy Of The Treatment Of Complex Tibial Plateau Fractures Using Different Methods

Objective：Discussion on the modified dual plate fixation, locking plate fixedwith external fixator combined with limited internal fixation of three surgical methodsfor treatment of complex tibial plateau fracture indications and its clinical efficacy,and provide a theoretical basis to choose the right treatment in the clinical.Methods： Retrospective analysis, analysis of the orthopedic Wuhai CityPeople’s Hospital in June2006to December2011using the modified double platefixation, locking plate internal fixation, external fixation and limited within a fixedthree different methods of treatment90cases of complex tibial plateau fractures inpatients with clinical data and radiological results, the modified double plate fixationgroup,30cases,30cases of locking plate fixation group, the external fixatorcombined with limited internal fixation group,30cases were examined by the patientreferral and follow-up of means of communication10months to2years, an average of18months. From the operation time, blood loss, hospital stay, fracture healing time,load time, complications, knee activity and knee function recovery (good rate), acomparative evaluation of three different treatment and for statistical analysis.Results：Locking plate group, the group of the double plate and external fixatorgroup in the tourniquet under the operation, intraoperative blood loss was notstatistically significant.External fixator group and the locking plate group operativetime and the time of fracture healing is basically the same, the difference was not statistically significant, shorter than the dual-plate group, the difference wasstatistically significant.Three groups of hospital stay, time to full weight bearing and1year after surgery, knee action angle less, The difference was not statisticallysignificant. One year after surgery, according to Rasmussen tibial condyle fracturesKnee Society function score to the locking plate group was slightly higher than theother two groups, but the three groups showed no significant difference (P>0.05).Three groups of postoperative complications incidence was no significantdifference (P>0.05), these three groups are not deep infection, screw breakage, plateloosening and fracture, delayed union or nonunion, deep vein thrombosiscomplicationof fat embolism syndrome and compartment syndrome. In order to detect themechanical stability, compared three groups of patients with surgery, immediatelyafter surgery after3months and12months after surgery, TPA and PA in degrees:external fixator is poor compared with other groups, but three groups of patientssurgeryafter follow-up period PA and TPA angle change or less, the difference wasnot statistically significant (P>0.05), which indicates that the mechanical stability ofthree fixation methods.Conclusions：1. Modified double plate, locking plate fixed, external fixation combined with limitedinternal fixation for complex tibial plateau fractures Satisfactory results were obtained,but has its own advantages and complement each other.2. External fixator group and the locking plate group operative time and the time offracture healing is basically the same, the difference was not statistically significant,shorter than the dual-plate group, the difference was statistically significant.3. Three surgical methods: intraoperative blood loss, hospital stay, post-operative complication rate, full weight bearing time, the mechanical stability of immediately,three months and twelve months after surgery, the knee action angle and Rasmussentibial fractures knee function score one year after surgery, they are not statisticallysignificant difference (P>0.05).