后内侧联合前外侧手术入路治疗复杂性胫骨平台骨折的效果观察  

The effect of posterior medial combined anterolateral approach for the treatment of complex tibial plateau fractures

作　　者：陈添和[1] 陈小虎[1] 郭强[1] 杨忠汉[1] CHEN Tianhe;CHEN Xiaohu;GUO Qiang;YANG Zhonghan(The First Affiliated Hospital of Zhongshan University, Huiya Hospital, Huizhou 516081, China)

机构地区：[1]中山大学附属第一医院惠亚医院,广东惠州516081

出　　处：《中国医药科学》2018年第4期242-245,共4页China Medicine And Pharmacy

摘　　要：目的观察后内侧联合前外侧手术入路治疗复杂性胫骨平台骨折的效果。方法选取2012年12月~2016年12月于我院接受手术治疗的52例复杂性胫骨平台骨折病例纳入研究,均行后内侧联合前外侧手术入路治疗,对其完整临床诊治资料进行分析,比较术前健侧与术后当天、术后当天与术后1年胫骨平台后倾角(PS)、内翻角(PT)、手术前与术后1年膝关节活动度,并观察术后并发症情况、膝关节功能(Rasmussen)评分。结果患者术前健侧与术后当天、术后当天与术后1年胫骨平台PS与PT比较无统计学意义(P>0.05);与手术前比较,患者术后1年膝关节活动度明显增加(P<0.05);患者骨折愈合时间(4.62±1.03)个月,术后钢板固定良好,膝关节功能恢复优26例(50.00%),良19例(36.54%),可5例(9.61%),差2例(3.85%);术后切口全部达到一期愈合,没有产生切口感染、下肢深静脉血栓或者皮肤坏死等严重并发症。结论后内侧联合前外侧手术入路治疗复杂性胫骨平台骨折,可获得确切疗效,促进膝关节活动与功能的恢复,且术后并发症少。Objective To observe the effect of the medial posterior combined anterolateral approach for the treatment of complex tibial plateau fractures.Methods Fifty-two patients with complex tibial plateau fractures treated in our hospital from December2012to December2016were selected.The patients were treated with the posterior medial anterolateral approach.The complete clinical diagnosis and treatment data were analyzed.The tibial plateau posterior tilt angle(PS),PT angle,and the range of motion of knee joint before operation and1years after operation were compared between those on the healthy side and the postoperative day,the day after operation and1years after operation.The postoperative complications and the score of knee function(Rasmussen)were observed.Results There were no statistically significant differences in the tibial plateau PS and PT between the preoperative uninjured side and the postoperative day and between the postoperative day and at1year after operation(P>0.05).Compared with those before operation,the knee mobility of the patients was increased significantly at1year after operation(P<0.05).The fracture healing time was(4.62±1.03)months with good postoperative plate fixation,and the knee joint function recovery was excellent in26cases(50.00%),good in19cases(36.54%),fair in5cases(9.61%)and poor in2cases(3.85%).All the wounds healed by first intention after the operation,and there were no serious complications such as infection of incision,deep vein thrombosis of lower extremity,or skin necrosis.ConclusionPosteromedial combined with anterolateral operative approach for the treatment of complex tibial plateau fractures can achieve definite curative effect,promote knee joint activity and function recovery,and has fewer postoperative complications.

关 键 词：联合手术入路 复杂性胫骨平台骨折 愈合 效果 

分 类 号：R687.3[医药卫生—骨科学]