Clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱ tibial plateau fracture

DING Hui-hai; HAN Cheng-xiang; CUI Jian-guo

doi:10.11659/jjssx.01E024054

您当前的位置：

首页 >

文章列表页 >

Clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱ tibial plateau fracture

Clinical Research | 更新时间：2025-05-26

- Clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱ tibial plateau fracture
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 5, Pages: 435-439(2025)
- 作者机构：
  
  1.连云港市立东方医院骨科，江苏连云港 222042
  2.连云港市立东方医院骨科急诊外科，江苏连云港 222042
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E024054
  CLC： R683.42
- Received：11 January 2024，
  
  Published：25 May 2025
- 稿件说明：
移动端阅览
丁辉海,韩成相,崔建国.不同植骨材料在SchatzkerⅡ型胫骨平台骨折内固定术中的应用效果[J].局解手术学杂志,2025,34(05):435-439.

DING Hui-hai,HAN Cheng-xiang,CUI Jian-guo.Clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱ tibial plateau fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):435-439.
丁辉海,韩成相,崔建国.不同植骨材料在SchatzkerⅡ型胫骨平台骨折内固定术中的应用效果[J].局解手术学杂志,2025,34(05):435-439. DOI： 10.11659/jjssx.01E024054.

DING Hui-hai,HAN Cheng-xiang,CUI Jian-guo.Clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱ tibial plateau fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):435-439. DOI： 10.11659/jjssx.01E024054.

摘要

目的

探究不同植骨材料在SchatzkerⅡ型胫骨平台骨折内固定术中的应用效果。

方法

选取连云港市立东方医院108例Schatzker Ⅱ型TPF患者，随机分为异体松质骨组和人工骨组，每组54例。比较2组患者围术期情况、手术前后凝血四项[凝血酶时间（TT）、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）]、骨代谢因子[骨钙素（BGP）、碱性磷酸酶（ALP）、Ⅰ型前胶原氨基端前肽（PINP）]、膝关节活动度、数字等级量表（NRS）评分、并发症、预后及植骨稳定性。

结果

人工骨组患者住院时间、骨折愈合时间短于异体松质骨组（

0.05）；术后第7天，人工骨组患者外周血APTT、TT、PT长于异体松质骨组，FIB水平低于异体松质骨组（

0.05）；术后3个月，2组患者血清ALP、BGP、PINP水平均高于术前（

0.05）；术后3个月，人工骨组患者膝关节伸展度、屈曲度大于异体松质骨组，NRS评分低于异体松质骨组（

0.05）；人工骨组患者并发症发生率低于异体松质骨组（

0.05）；术后6个月，人工骨组患者膝关节功能恢复优良率高于异体松质骨组（

0.05）；术后12个月，人工骨组患者胫骨外髁关节面总体塌陷高度、外侧间隙角总体增加角度、外侧间隙总体丢失高度低于异体松质骨组（

0.05）。

结论

与异体松质骨相比，Schatzker Ⅱ型TPF患者内固定术中选择人工骨作为植骨材料能更有效改善术后凝血功能状态，降低并发症发生率，增加植骨稳定性，有助于改善预后。

Abstract

Objective

To investigate the clinical effects of different bone graft materials in internal fixation surgery for Schatzker type Ⅱtibial plateau fracture （TPF）.

Methods

A total of 108 patients with Schatzker type Ⅱ TPF in Lianyungang Municipal Oriental Hospital were selected and randomly assigned to the allogeneic cancellous bone and the artificial bone groups，with 54 cases in each group. The perioperative indicators，four coagulation items ［thrombin time （TT），fibrinogen （FIB），activated partial thromboplastin time （APTT），prothrombin time （PT）］，bone metabolic factors ［bone gla protein （BGP），alkaline phosphatase （ALP），precollagen typeⅠ N-terminal peptide（PINP）］，knee motion，and numerical rating scale （NRS）score before and after operation，as well as complications，prognosis，bone graft stability were compared in the two groups.

Results

The hospital stay and fracture healing time in the artificial bone group were shorter than those in the allogeneic cancellous bone group （

0.05）. On the 7th day after surgery，the artificial bone group had longer peripheral blood APTT，TT and PT than the allogeneic cancellous bone group，and lower FIB level than the allogeneic cancellous bone group（

0.05）. The serum ALP，BGP and PINP levels 3 months after surgery in the two groups were higher than those before surgery （

0.05）. At 3 months after surgery，the ranges of knee extension and flexion in the artificial bone group were greater than those in the allogeneic cancellous bone group （

0.05），and the NRS score was lower than that in the allogeneic cancellous bone group （

0.05）. The incidence of complications in the artificial bone group was lower than that in the allogeneic cancellous bone group （

0.05）.The excellent and good rate of knee joint function recovery 6 months after surgery in the artificial bone group was higher than that in the allogeneic cancellous bone group （

0.05）.The overall collapse height of the tibial lateral condylar articular surface，overall increase of lateral compartment angle，and overall loss height of lateral compartment 12 months after surgery in the artificial bone group were lower than those in the allogeneic cancellous bone group （

0.05）.

Conclusion

Compared with allogeneic cancellous bone，the use of artificial bone as the graft material during internal fixation in patients with Schatzker type Ⅱ TPF can more effectively ameliorate the postoperative coagulation status，reduce the incidence of complications，and enhance the graft stability，which is conducive to better prognosis.

关键词

Keywords

references

Rudran B ， Little C ， Wiik A ， et al . Tibial plateau fracture： anatomy，diagnosis and management ［J］. Br J Hosp Med （Lond）， 2020 ， 81 （ 10 ）： 1 - 9 . doi： 10.12968/hmed.2020.0339 http://dx.doi.org/10.12968/hmed.2020.0339 .

位锋，周业金，姚涛，等 . Schatzker Ⅱ型胫骨平台骨折切开复位内固定联合自体髂骨植骨或固体硫酸钙植骨的疗效比较［J］. 中国骨与关节损伤杂志， 2021 ， 36 （ 2 ）： 191 - 193 . doi： 10.7531/j.issn. 1672-9935.2021.02.028 http://dx.doi.org/10.7531/j.issn.1672-9935.2021.02.028 .

Prall WC ， Rieger M ， Fürmetz J ， et al . Schatzker Ⅱ tibial plateau fractures： anatomically precontoured locking compression plates seem to improve radiological and clinical outcomes ［J］. Injury ， 2020 ， 51 （ 10 ）： 2295 - 2301 . doi： 10.1016/j.injury.2020.07.012 http://dx.doi.org/10.1016/j.injury.2020.07.012 .

Hofmann A ， Gorbulev S ， Guehring T ， et al . Autologous iliac bone graft compared with biphasic hydroxyapatite and calcium sulfate cement for the treatment of bone defects in tibial plateau fractures： a prospective，randomized，open-label，multicenter study ［J］. J Bone Joint Surg Am ， 2020 ， 102 （ 3 ）： 179 - 193 . doi： 10.2106/JBJS.19.00680 http://dx.doi.org/10.2106/JBJS.19.00680 .

Cooper GM ， Kennedy MJ ， Jamal B ， et al . Autologous versus synthetic bone grafts for the surgical management of tibial plateau fractures： a systematic review and meta-analysis of randomized controlled trials ［J］. Bone Jt Open ， 2022 ， 3 （ 3 ）： 218 - 228 . doi： 10.1302/2633-1462.33.BJO-2021-0195.R1 http://dx.doi.org/10.1302/2633-1462.33.BJO-2021-0195.R1 .

董佳增，何建明，周峰，等 . 同种骨植入材料应用于颌骨缺损的临床效果观察［J］. 口腔医学， 2018 ， 38 （ 11 ）： 1007 - 1010 . doi： 10.13591/j.cnki.kqyx.2018.11.012 http://dx.doi.org/10.13591/j.cnki.kqyx.2018.11.012 .

中华创伤骨科杂志编辑委员会 . 胫骨平台骨折诊断与治疗的专家共识［J］. 中华创伤骨科杂志， 2015 ， 17 （ 1 ）： 3 - 7 . doi： 10.3760/cma.j.issn.1671-7600.2015.01.002 http://dx.doi.org/10.3760/cma.j.issn.1671-7600.2015.01.002 .

Chiarotto A ， Maxwell LJ ， Ostelo RW ， et al . Measurement properties of visual analogue scale，numeric rating scale，and pain severity subscale of the brief pain inventory in patients with low back pain：a systematic review ［J］. J Pain ， 2019 ， 20 （ 3 ）： 245 - 263 . doi： 10.1016/j.jpain. 2018.07.009 http://dx.doi.org/10.1016/j.jpain.2018.07.009 .

Ahmed KM ， Said HG ， Ramadan EKA ， et al . Arabic translation and validation of three knee scores，Lysholm knee score （LKS），Oxford knee score （OKS），and International Knee Documentation Committee Subjective Knee Form （IKDC）［J］. SICOT J ， 2019 ， 5 （ 1 ）： 6 . doi： 10.1051/sicotj/2018054 http://dx.doi.org/10.1051/sicotj/2018054 .

崔万勇，白冰 . 切开复位内固定结合羟基磷灰石支撑自体骨植骨钢板治疗Schatzker Ⅱ型胫骨平台骨折的效果与安全性［J］. 临床误诊误治， 2022 ， 35 （ 11 ）： 84 - 88 . doi： 10.3969/j.issn.1002-3429.2022.11.018 http://dx.doi.org/10.3969/j.issn.1002-3429.2022.11.018 .

汪建军，代胡明，经保生 . 三种骨移植物填充复杂胫骨平台骨折骨缺损比较［J］. 中国矫形外科杂志， 2021 ， 29 （ 4 ）： 294 - 297 . doi： 10.3977/j.issn.1005-8478.2021.04.02 http://dx.doi.org/10.3977/j.issn.1005-8478.2021.04.02 .

徐宗联 . 两种植骨材料对骨质疏松性Schatzker Ⅱ型胫骨平台骨折患者植骨强度及稳定性的影响［J］. 罕少疾病杂志， 2023 ， 30 （ 6 ）： 68 - 70 . doi： 10.3969/j.issn.1009-3257.2023.06.028 http://dx.doi.org/10.3969/j.issn.1009-3257.2023.06.028 .

孙莲莲，刘永超，王志兴 . 同步辐射成像比较两种不同骨修复材料修复兔股骨缺损的效果［J］. 中国组织工程研究， 2023 ， 27 （ 21 ）： 3343 - 3348 . doi： 10.12307/2023.460 http://dx.doi.org/10.12307/2023.460 .

易刚，张磊，扶世杰，等 . 双钢板固定结合奥邦植骨材料与自体髂骨植骨治疗复杂胫骨平台骨折的比较［J］. 中国组织工程研究， 2019 ， 23 （ 16 ）： 2486 - 2492 . doi： 10.3969/j.issn.2095-4344.1204 http://dx.doi.org/10.3969/j.issn.2095-4344.1204 .

Liu DW ， Zhu YB ， Chen W ， et al . Relationship between the inflammation/immune indexes and deep venous thrombosis （DVT） incidence rate following tibial plateau fractures ［J］. J Orthop Surg Res ， 2020 ， 15 （ 1 ）： 241 . doi： 10.1186/s13018-020-01765-9 http://dx.doi.org/10.1186/s13018-020-01765-9 .

马慧，同红伟 . 硬膜外麻醉联合全麻对胫骨平台骨折患者凝血功能的影响［J］. 血栓与止血学， 2022 ， 28 （ 3 ）： 813 - 814 . doi： 10.3969/j.issn.1009-6213.2022.03.209 http://dx.doi.org/10.3969/j.issn.1009-6213.2022.03.209 .

郑泓，李伟强，翁天才 . 磷酸钙自固化人工骨填充配合小切口复位治疗胫骨平台骨折的效果［J］. 黑龙江医药， 2022 ， 35 （ 5 ）： 1031 - 1034 . doi： 10.14035/j.cnki.hljyy.2022.05.013 http://dx.doi.org/10.14035/j.cnki.hljyy.2022.05.013 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Adenosine A3 receptor promotes epithelial-mesenchymal transition in glioma and its effect on prognosis

Clinical analysis of arthroscopic modified suture-bridge surgery for full-thickness rotator cuff injury in elderly patients

Effect of fine needle aspiration technique on laparoscopic thyroid surgery

Diagnostic value of 62-slice spiral CT and its post-processing techniques for tibial plateau fracture and its classification

Correlation between the expression of TLR4 and CHI3L1 in colon cancer tissue and the prognosis after radical surgery

Related Author

CHENG Gong

TONG Xiang

XU Meng

CAI Qiang

GE Rui

PENG Peng

ZANG Jian

XU Peng

Related Institution

Department of Neurosurgery，Honghu People's Hospital， Honghu Hubei

Department of Neurosurgery，Renmin Hospital of Wuhan University

Department of Critical Care Medicine，Honghu People's Hospital，Honghu Hubei

Second Department of Bone Injury，Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine

Graduate School of Jinzhou Medical University

⁰