不同手术入路治疗累及双髁后侧复杂性胫骨平台骨折的效果比较  

Comparison of clinical effect in different surgical approaches for complex tibial plateau fractures involving the rear double condyle

作　　者：邹锦考[1] 张庆林[1] 赵平[1] 杨影[1] 邓国权[1] 陈清丽[1] 黄斌学[1] 

机构地区：[1]广东省东莞市桥头医院骨科,523523

出　　处：《白求恩医学杂志》2014年第3期216-218,共3页Journal of Bethune Medical Science

摘　　要：目的比较后内侧倒L形入路联合前外侧入路内固定与前内侧联合前外侧入路内固定治疗累及双髁后侧复杂性胫骨平台骨折的临床效果。方法 53例累及双髁后侧复杂性胫骨平台骨折患者,接受前内侧联合前外侧入路内固定29例（对照组）,后内侧倒L形入路联合前外侧入路内固定24例（观察组）,比较两组膝关节评分（HSS）、骨折愈合时间及并发症发生情况。结果经12-26个月随访,观察组HSS评分总优良率高于对照组（P〈0.05）,术后并发症发生率低于对照组（P〈0.05）;两组骨折愈合时间差异无统计学意义（P〉0.05）。结论对累及双髁后侧复杂性胫骨平台骨折,通过后内侧倒L形入路联合前外侧入路内固定治疗能提供良好的显露,损伤小,有利于骨折复位固定,且术后并发症少,是一种较为理想的手术方法。Objective To compare the clinical effect between posteromedial inverted L shape combined with anterior lateral approach and anteromedial combined with anterior lateral in treatment for complex tibial plateau fractures involving the rear double condyle. Methods Fifty-three cases of complex tibial plateau fractures involving the rear double condyle who had been operated on were retrospectively analyzed,including 29 cases of anteromedial combined with anterior lateral（ control group） and 24 cases of posteromedial inverted L shape combined with anterior lateral（ observation group）. Knee function rehabilitation,fracture union time and the rate of complications were evaluated. Results A 12-26 month-follow-up showed that the excellence rate of observation group was higher than that of control group（ P〈0.05）,but postoperative complication rate was lower than that of control group（ P〈0.05）. The difference of fracture union time in two groups was not statistically significant（ P〉0.05）. Conclusion Posteromedial inverted L shape combined with anterior lateral approach in treatment of complex tibial plateau fractures involving the rear double condyle can provide excellent exposure with less invasion and facilitate fracture reduction with less complications as an ideal surgical approach.

关 键 词：胫骨平台骨折 手术入路 内固定 

分 类 号：R687.3[医药卫生—骨科学]