前后联合入路治疗复杂胫骨平台骨折的疗效分析  

Analysis of effect of combined anterior and posterior approach for treatment of complex tibial plateau fractures

作　　者：陆黎明[1] 刘进炼[1] 张叶松[1] 凡桂勇[1] 孙斌[1] Li-ming Lu;Jin-lian Liu;Ye-song Zhang;Gui-yong Fan;Bin Sun(Department of Orthopedics,Suzhou Kowloon Hospital Affiliated to School of Medicine, Shanghai Jiaotong University,Suzhou,Jiangsu 215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院骨科,江苏苏州215000

出　　处：《中国现代医学杂志》2018年第35期98-101,共4页China Journal of Modern Medicine

摘　　要：目的探讨前后联合入路在治疗复杂胫骨平台骨折的疗效。方法选取2012年6月—2014年6月于上海交通大学医学院附属苏州九龙医院入住的124例胫骨平台骨折患者,随机分为实验组(行前后联合入路手术)与对照组(膝前正中入路手术),对两组患者的临床疗效进行比较分析。结果患者均获18～37个月随访,平均(24±6)个月;两组患者骨折愈合时间、切口感染及内固定失效比较,差异有统计学意义(P <0.05)。两组患者日常生活功能、步态、膝关节稳定度、活动范围及Merchant量表总分比较,差异有统计学意义(P <0.05)。结论胫骨平台骨折的手术治疗中,前后联合入路会缩短骨折愈合时间,减少伤口感染及内固定失效概率,但不能减轻患者疼痛。在术后恢复过程中前后联合入路手术方式要优于膝前正中入路。Objective To explore the curative effect of combined anterior and posterior approach in the treatment of complex tibial plateau fractures.Methods A total of 124 patients with tibial plateau fractures admitted to Suzhou Kowloon Hospital Affiliated to School of Medicine,Shanghai Jiaotong University from June 2013 to June 2017 were selected and randomly divided into an experimental group(64 cases receiving routine combined anterior and posterior approach operation)and a control group(60 cases undergoing knee anterior median approach surgery).The clinical efficacy of the two groups was compared.Results All 124 patients were followed up for 18-37 months with an average of(24±6)months.There were significant differences in the average fracture healing time,incision infection and internal fixation failure between the two groups(P<0.05).The total score of Merchant scale,daily activities,gait,stability of the knee joint and range of activity were significantly different between the two groups(P<0.05).Conclusions In surgical treatment of tibial plateau fractures,the combined anterior and posterior approach can shorten the healing time of the fracture,reduce the probability of wound infection and internal fixation failure,but can not relieve the pain.In the postoperative recovery process,the combined approach surgery is superior to the knee anterior median approach surgery.

关 键 词：胫骨骨折 骨折固定术 治疗结果 随访研究 

分 类 号：R605.97[医药卫生—急诊医学]