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目的 对比分析 Hybrid 外固定架与钢板内固定治疗胫骨平台骨折的临床疗效.方法 选取2015 年 1 月至 2017 年 1 月青海大学附属医院收治的 Schatzker 分型 IV、V、VI 型胫骨平台骨折患者 60 例.其中男 40 例,女 20 例;年龄 19~54 岁,平均 ( 42.7±8.9 ) 岁,车祸伤 20 例,高处坠落伤 25 例,摔倒伤15 例,其中 IV 型 15 例,V 型 30 例,VI 型 15 例.不包括侧副韧带、前后交叉韧带完全断裂,骨筋膜室综合征及神经、血管损伤的病例,无合并有严重的其它慢性疾病.按手术方法分成两组:Hybrid 外固定架组( A 组 ) 30 例,其中男 20 例,女 10 例;切开复位钢板内固定组 ( B 组 ) 30 例,其中男 19 例,女 11 例.结果60 例均获随访 6~9 个月,平均 8 个月.平均手术时间 ( P=0.038 )、平均术中出血量 ( P=0.042 ) 及平均骨折愈合时间 ( P=0.016 ),差异均有统计学意义;RRS 评分 ( P=0.27 )、Lysholm 评分 ( P=0.14 )、皮肤坏死率( P=0.16 ) 及伤口感染率 ( P=0.18 ),差异无统计学意义 ( P>0.05 ).结论 Hybrid 外固定架结合小切口有限内固定较钢板内固定治疗胫骨平台骨折疗效显著,操作简单,创伤小,骨折愈合时间短,降低术后感染率,有一定临床应用价值.“,”Objective To compare Hybrid external fixator + limited fixation with small incision and traditional plate fixation in the treatment of the tibial plateau fracture. Methods From January 2015 to January 2017, 60 patients with Schatzker fracture type IV ( 15 cases ), V ( 30 cases ), VI ( 15 cases ) were selected. There were 40 males and 20 females. The mean age was ( 42.7 ± 8.9 ) years ( range: 19 - 54 years ). Twenty cases were of traffic accident injury, 25 cases of falling injury, and 15 cases of fall over injury. Patients with complete rupture of the collateral ligaments and anterior cruciate ligaments, compartment syndrome, nerve or vascular injury, and other serious chronic diseases were excluded. According to surgical methods, the patients were divided into two groups: Hybrid external fixator group ( Group A, n = 30, 20 males and 10 females ); open reduction and internal fixation group ( Group B, n = 30, 19 males and 11 females ). Results Sixty patients were followed up for 6 to 9 months ( average: 8 months ). Significant differences ( P 0.05 ) existed in RRS ( P = 0.27 ), lysholm ( P = 0.14 ), skin necrosis rate ( P = 0.16 ) and wound infection rate ( P = 0.18 ). Conclusions Clinical results of Hybrid external fixator + limited fixation with small incision are more satisfactory than the traditional plate fixation in the treatment of the tibial plateau fracture. It shortens the healing time, lowers the infection rate, simplifies the operation , which is also less invasive.