| Objective: To compare the therapeutic effects of common anatomical plate andlocking plate implantation in treatment of patients with complex tibial plateaufractures.Methods: From January2008to January2011,27patients with complex tibialplateau fractures were treated with common anatomical plate and locking plate. Theirfunctional and radiographic outcomes were retrospectively analyzed to compare thedifferences in surgical operation time,bleeding volume during surgical operation,fracture healing time, full weight-bearing time, tibial plateau angle(TPA) and posteriorslope angle(PA), knee joint’s HSS(The Hospital for Special Surgery) scores, woundhealing and complication were observed.Results: The27cases had complete follow-up records and a mean follow-up of15.6months(range,12to20months).1.In the group of common anatomical plate implantation, the mean surgicaloperation time was130.40minutes(range,90to180minutes), the mean bleedingvolume during surgical operation was323.33milliliters(range,200to450milliliters),the mean fracture healing time was15.47weeks(range,11to23weeks), the mean fullweight-bearing time was16.53weeks(range,11to25weeks), the mean HSS scores ofpost-operation12months was85.07points(range,63to94points). In the group oflocking plate implantation, the mean surgical operation time was118.33minutes(range,90to160minutes), the mean bleeding volume during surgical operation was299.17milliliters(range,180to400milliliters), the mean fracturehealing time was14.08weeks(range,9to18weeks), the mean full weight-bearingtime was14.75weeks(range,10to19weeks), the mean HSS scores of post-operation12months was88.42points(range,66to96points). There were no significantdifferences between the two groups in the above parameters(P＞0.05).2.There were no significant differences between the two groups in change ofTPA and PA in the various follow-up period, there were no significant differencesbetween the various follow-up period in change of TPA and PA(P＞0.05).3.In the group of common anatomical plate implantation,1case of partialsuperficial skin infection resulting in delayed healing,1case of partial skin necrosisand bone exposure, no occurrence of deep infection case. In the group of locking plateimplantation, no occurrence of superficial skin infection or necrosis and deepinfection case. There was no significant differences between two groups in rate ofinfection. In the group of common anatomical plate implantation,2cases of fracturedelayed union,1case developed loose of screw, without breakage of internal fixation.In the group of locking plate implantation,1case of fracture delayed union.Conclusions:1.As to complex tibial plateau fractures, preoperative evaluation of injurymechanism, according to radiographic information to make clear the fractureclassification, paying close attention to the soft tissue injury, making a careful choiceof surgical approach.2.Applying the correct principles and techniques, common anatomical plate andlocking plate can provide good fixation for the complex tibial plateau fractures, theclinical therapeutic effects of them are similar. |
