关键词: 双切口, 双钢板, 内固定, 老年, 胫骨平台骨折

Abstract: Objective  To investigate the clinical effect of dual incision and dual plate internal fixation for the treatment of tibial plateau fractures in the elderly and its impact on knee joint function.Methods  Using retrospective analysis method,103 elderly patients with tibial plateau fractures admitted to Rugao Hospital affiliated to Nantong University from April 2015 to May 2021 were selected for clinical research.According to the surgical method,they were divided into two groups,52 patients in the study group were treated with double incision double plates,and 51 patients in the control group were treated with locking plate internal fixation.Perioperative indicators,knee function,knee stability Knee joint complications.Results The hospitalization time of the study group was (7.8±2.0) days, and that of the control group was (10.0±2.4) days, and the difference was statistically significant between the two groups (P<0.05).The HSS scores at 3 months, 6 months and 12 months were (66.9±5.4), (78.4±6.6) and (83.8±6.1) in the study group, and (64.2±6.1), (74.0±7.3) and (82.0±6.8) in the control group, respectively. There was statistical significance in HSS scores 3 months and 6 months after operation between the two groups (P<0.05).The tibial migration distance 3 months after operation was (2.54±0.50) mm in the study group and (2.84±0.67) mm in the control group, and the difference was statistically significant (P<0.05).The knee posterior inclination angles of the study group were (4.12±1.10) °, (5.03±0.96) ° and (5.46±1.52) ° at 3 months, 6 months and 12 months after surgery, respectively, while those of the control group were (6.11±1.43) °, (6.67±1.54) ° and (7.50±1.88) °, respectively. The difference was statistically significant (P<0.05).The activity of the study group at 3 months and 6 months after surgery was (104.3±8.2) ° and (117.4±7.6) °, respectively, while that of the control group was (96.8±8.9) ° and (111.8±8.2) °, and the difference was statistically significant (P<0.05).There were 3 cases of postoperative complications in the study group and 10 cases in the control group, and the difference was statistically significant (P<0.05).Conclusion  The clinical effect of dual incision and dual plate internal fixation in the treatment of tibial plateau fractures in the elderly is affirmative,which is more beneficial for promoting early recovery of knee function and maintaining stability of knee function than locking plate internal fixation.

Key words: double incision, double steel plate, internal fixation, old age, tibial plateau fracture