Research On Curative Effect Of Two Kinds Of Internal Fixation For Treatment Of Schatzker Type Ⅱ Tibial Plateau Fractures Involving The Posterior Column

Objective: By comparing the effects of the bamboo raft-type locking plate and golf-type locking plate in curing Schatzker type Ⅱ tibial plateau fractures involving the posterior column, this research aims at getting the optimum fixed mode of Schatzker type Ⅱ tibial plateau fractures involving the posterior column and provides reference for reasonably selecting clinical internal fixation material.Methods: According to the case inclusion criteria as well as exclusion criteria, this study selects 60 cases of Schatzker type Ⅱ tibial plateau fractures involving the posterior column from Shandong Province Hospital of Traditional Chinese Medicine during the period of September 2014 to September 2015, which are divided into A, B two groups based on random number method. The patients in both groups adopt the method of surgical operation and internal fixation combined with traditional Chinese medicine orally taken. Besides, the patients in A group choose bamboo raft-type locking plate as their internal fixation material(hereinafter called the bamboo raft-type locking plate group), while those in B group choose golf-type locking plate(hereinafter called the golf-type locking plate group). All of the patients will get follow-up visit to take the knee joint lateral slice in half a month, one month, two months, three months and four months after the operation. In addition, they will be graded after four months post-operation with reference to American special surgery hospital knee HSS scoring criteria. And then fill the Schatzker type Ⅱ tibial plateau fractures involving the posterior column patient review table.Results:(1)All of the 60 cases involved in this study get follow-up visit which lasts for four months and all their fractures reach Clinical healing standard.(2)In A group after four months post-operation, average HSS score reaches 82.57±9.20, with 16 cases for excellent, 14 for good, 4 for fair and 0 for bad, whose excellent and good rate is 86.67%. While in B group, average HSS score reaches 73.90±14.26, with 9 cases for excellent, 11 for good, 4 for fair and 6 for bad, whose excellent and good rate is 66.67%. Function of the knee score of group A is higher than that of group B by 8.67 points, the excellent and good rate of group A is higher than that of group B by 20 percent. According toχ2 Test, the value of P is 0.046, which has statistical significance.(3)The joint surface subsidence degree of group A is 0.20±0.67 mm on average, subsidence rate is 10 percent. While the joint surface subsidence degree of group B is 0.83±1.49 mm on average, 0.63 mm higher than that of group A. The subsidence rate of group B is 30 percent, 20 percent higher than that of group A. All of the figures bear statistical significance.(4)The bone block shift degree of group A is 0.23±0.68 mm on average, shift rate is 13.33 percent. While the bone block shift degree of group B is 0.63±1.03 mm on average, 0.40 mm higher than that of group A. The shift rate of group B is 30 percent, 16.67 percent higher than that of group A.Conclusion: This study indicates that the bamboo raft-type locking plate is superior to the golf-type locking plate in the early process of curing Schatzker type Ⅱ tibial plateau fractures involving the posterior column.