改良膝后侧入路治疗胫骨近端后侧骨折的临床观察  

Clinical Effect of Modified Posterior Knee Approach in the Treatment of Proximal Posterior Tibial Fracture

作　　者：欧锐金 谭建基 唐灿锐 谭文乐 黄东博 OU Ruijin;TAN Jianji;TANG Canrui;TAN Wenle;HUANG Dongbo(Luoding People's Hospital,Luoding 527200,China)

机构地区：[1]罗定市人民医院

出　　处：《现代医院》2019年第11期1640-1643,共4页Modern Hospitals

基　　金：云浮市医学科学技术研究项目(2018B49)

摘　　要：目的探讨改良膝后侧入路治疗胫骨近端后侧骨折的临床效果。方法选取2013年1月—2018年12月医院收治的胫骨近端后侧骨折的患者资料112例,随机等分为对照组(膝前外侧入路治疗)和研究组(改良膝后侧入路治疗),每组56例。比较两组的临床资料、治疗前后膝关节功能评分、治疗前后膝关节活动度以及临床疗效的评定,并对其进行分析。结果治疗后,研究组的临床症状较对照组有明显的改善,研究组手术时间、恢复工作时间以及骨折愈合时间均显著低于对照组(P<0.05);两组患者膝关节功能HSS评分和Lysholm评分治疗前后评分有统计学差异(P<0.05),研究组的两种评分较对照组均呈现上升趋势;研究组伸膝最大角度显著高于对照组(P<0.05);研究组临床疗效的优良率明显超过对照组患者(P=0.000)。结论对胫骨近端后侧骨折患者采取改良膝后侧入路进行治疗,方法安全有效,具有有效减少治疗时间、膝关节功能恢复良好、不良反应及并发症少、疗效显著的优点,有极强的临床推广价值。Objective To explore the clinical effect of modified posterior knee approach in the treatment of proximal posterior tibial fracture.Methods A total of 112 patients with proximal posterior tibial fracture admitted to our hospital during January 2013 to December 2018 were randomized as the control group(anterior lateral knee approach)and the research group(modified posterior knee approach)with 56 cases each group.The two groups were compared in terms of the clinical data,scores of knee function and degree of motion of knee before and after treatment and clinical efficacy.Results The clinical symptoms in the research group were significantly improved compared with the control group.The operation time,recovery time and fracture healing time of the research group were significantly lower than those of the control group(P<0.05).HSS and Lysholm scores were used to evaluate the knee function scores of the patients.The scores of the two groups were significantly different before and after the intervention(P<0.05).The two scores of the research group showed an increasing trend compared with the control group.After treatment,the maximum angle of knee extension of the research group was significantly higher than that of the control group(P<0.05).The excellent and good rate of clinical efficacy in the study group was significantly higher than that in the control group(P=0.000).Conclusion The modified posterior knee approach is safe and effective in the treatment of patients with proximal tibial fracture.It has the advantages of reduced treatment time,good recovery of knee joint function,less adverse reactions and complications and significant efficacy.It is of value to spread it in clinical practice.

关 键 词：膝后侧入路 膝外侧入路 胫骨近端 后侧骨折 临床疗效 

分 类 号：R683.420.5[医药卫生—骨科学]