Observation on the results of different bone graft ways in the treatment of tibial plateau fractures

TANG Pei; WU Xiao-bao; CHEN Xiao-jun; CHEN Wei; FAN Zhi-qiang

doi:10.3969/j.issn.2095-252X.2017.04.013

Abstract：Objective To investigate the results of different bone graft ways in the treatment of tibial plateau fractures. Methods A total of 45 cases of tibial plateau fractures treated in our hospital from March 2012 to June 2014 were selected as objects. According to the treatment methods, they were divided into 2 groups: fenestration tamping bone graft group ( n = 22 ) and packing bone graft group ( n = 23 ). The curative results, fracture reduction and healing of the 2 groups were observed, and early and late complications and Rasmussen scores of the knee joint were compared between the 2 groups. Results Wound healing time and time of callus occurrence were ( 18.96 ± 4.18 ) days and ( 5.53 ± 1.05 ) weeks in packing bone graft group, which were ( 19.02 ± 3.39 ) days and ( 5.62 ± 1.13 ) weeks in fenestration tamping bone graft group, and there were no obvious differences between the 2 groups. The surgical results of fenestration tamping bone graft group were significantly better than that of packing bone graft group, and the differences were statistically significant ( P = 0.035 ). There were no statistically significant differences in the incidence of postoperative complications such as deep venous thrombosis of the lower limb and fat liquefaction around the incision ( P = 0.673, 0.157, 0.301, 0.323 ) between the 2 groups. Rasmussen scores of the knee joint were ( 15.97 ± 2.13 ) and ( 16.02 ± 3.05 ), ( 18.36 ± 3.16 ) and ( 18.52 ± 3.23 ) at 3 and 6 months after the operation in the 2 groups, and there were no statistically significant differences between the 2 groups ( P = 0.475, 0.434 ). At 9 months after the operation, Rasmussen score of the knee joint was 26.45 ± 4.01 in fenestration tamping bone graft group, which was significantly higher than ( 23.62 ± 3.75 ) in packing bone graft group ( P = 0.009 ). Conclusions It is better to treat tibial plateau fractures with fenestration tamping bone graft than packing bone graft, with the advantages of excellent curative results, good prognosis of patients and low incidence of complications, which is also beneficial to the recovery of knee joint function.