中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (4): 578-582.doi: 10.12307/2022.752

• 骨科植入物 orthopedic implant • 上一篇    下一篇

T型接骨板在涉及髋臼四方区骨折治疗中的应用

陈  磊，贾燕飞，吕慧成，张立峰   

  1. 内蒙古医科大学第二附属医院，内蒙古自治区呼和浩特市   010030
  • 收稿日期:2021-08-24 接受日期:2021-11-19 出版日期:2023-02-08 发布日期:2022-06-23
  • 通讯作者: 贾燕飞，主任医师，内蒙古医科大学第二附属医院，内蒙古自治区呼和浩特市 010030
  • 作者简介:陈磊，男，1984年生，山东省成武县人，汉族，内蒙古医科大学在读硕士，主治医师，主要从事骨科医学研究。
  • 基金资助:
    内蒙古自然科学基金项目(2017MS08118)，项目负责人：吕慧成；内蒙古卫生计生科研计划项目(201703118)，项目负责人：吕慧成；内蒙古医科大学研究生教育教学改革研究项目(YJG202021)，项目负责人：吕慧成

Application of T-shaped plate for fractures involving the quadrilateral region of acetabulum

Chen Lei, Jia Yanfei, Lyu Huicheng, Zhang Lifeng   

  1. Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • Received:2021-08-24 Accepted:2021-11-19 Online:2023-02-08 Published:2022-06-23
  • Contact: Jia Yanfei, Chief physician, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • About author:Chen Lei, Master candidate, Attending physician, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • Supported by:
    Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2017MS08118 (to LHC); Health and Family Planning Research Project of Inner Mongolia Autonomous Region, No. 201703118 (to LHC); Graduate Education and Teaching Reform Research Project of Inner Mongolia Medical University, No. YJG202021 (to LHC)

PDF

30

摘要：

文题释义：
可塑性T型接骨板：国内比较常用，厚度约1.5 mm，其预弯及塑形能力强，适应多样的骨盆骨折块形状，对人体无损伤，经济性价比高。  
弹簧效应：将接骨板预弯，通过将钢板弯曲到一个轻微凸出的位置而产生的，并且当钢板固定在后柱上时，通过挂钩对碎片进行压缩，可以起到持续加压的张力带效用。

背景：研究表明，T型接骨板可以预弯成合适的角度及形状，阻挡髋臼四方区骨折块，特别是骨折线延伸到坐骨大切迹处的骨折。
目的：进一步探讨T型接骨板在髋臼四方区骨折手术中的应用效果。
方法：选择2018年1月至2020年4月于内蒙古医科大学第二附属医院接受髋臼骨折外科治疗的患者31例，其中18例患者联合应用重建接骨板与T型接骨板为试验组，术中根据骨折情况进行重建接骨板及T型接骨板的预弯，把T型接骨板头侧的横行板弯向尾端，使整个接骨板接近直角状，以匹配骨折处，固定四方区顶端的骨折块；13例未应用T型接骨板为对照组，其他操作同试验组。治疗后观察患者手术时间、术中出血量、手术切口长度及骨折愈合情况；评估骨折复位后的X射线评分及患侧髋关节功能。
结果与结论：①随访时间24-40周，四方区骨折在术中进行良好的复位后，试验组置入提前预弯成型的重建接骨板与T型接骨板，接骨板与骨面接触良好；②试验组手术时间长于对照组(P < 0.05)，术中出血量少于对照组(P < 0.05)；③骨折复位按Matta标准评价，试验组优良率89%(16/18)，对照组优良率85%(11/13)，试验组完全负重时间(7.9±1.6)周优于对照组(9.5±2.1)周(P < 0.05)；④结论：采用T型接骨板联合重建接骨板治疗涉及到髋臼四方区的骨折，复位效果好，操作简便，术中出血少，完全负重时间短。

https://orcid.org/0000-0002-8670-7984 (陈磊) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: T型接骨板, 髋臼四方区骨折, 内固定, 髋臼, 骨折

Abstract: BACKGROUND: Studies have shown that the T-shaped plate can be pre-bent to a suitable angle and shape to block the fracture fragments in the quadrilateral region of the acetabulum, especially the fracture line extending to the greater sciatic notch.  
OBJECTIVE: To investigate the effect of T-shaped plate in the operation of acetabular quadrilateral fracture. 
METHODS: Totally 31 patients who underwent acetabular fracture surgery in Second Affiliated Hospital of Inner Mongolia Medical University from January 2018 to April 2020 were selected as the research object, of which 18 patients were combined with reconstruction plate and T-shaped plate. During the operation, the reconstruction plate and pre-bending of T-shaped plate were carried out according to the fracture situation, and the transverse plate on the head side of T-shaped plate was bent to the tail end, making the whole plate close to a right angle to match the fracture and fix the fracture block at the top of the square area. The 13 patients were not applied with T-shaped plate as the control group. Other operations were the same as in the experimental group. After treatment, the operation time, intraoperative blood loss, incision length and fracture healing were observed; the X-ray score and the function of the affected hip were evaluated after fracture reduction.  
RESULTS AND CONCLUSION: (1) The patients were followed up regularly for 24-40 weeks. After good intraoperative reduction of quadrilateral fractures, pre- bent reconstruction plate and T-shaped plate were placed, and the plate was in good contact with the bone surface. (2) The operation time of the trial group was longer than that of the control group (P < 0.05), and the intraoperative blood loss was less than that of the control group (P < 0.05). (3) Fracture reduction was evaluated according to Matta standard. The excellent and good rate of the trial group was 89% (16/18), and the excellent and good rate of the control group was 85% (11/13). The complete weight-bearing time of the trial group [(7.9±1.6) weeks] was better than that of the control group [(9.5±2.1) weeks] (P < 0.05). (4) It is concluded that T-shaped plate combined with reconstruction plate involving fractures in the quadrilateral region of the acetabulum has a good reduction effect, simple operation, less intraoperative blood loss, and short complete weight-bearing time. 

Key words: T-shaped plate, fracture of acetabular quadrilateral region, internal fixation, acetahbulum, fracture

中图分类号: