后内侧联合前外侧入路治疗胫骨后外侧平台骨折  

Treatment of posterolateral tibial plateau fractures with the posteromedial and anterolateral approaches

作　　者：张海龙[1] 管国平[1] 殷建 葛雨庆 刘新晖[1] ZHANG Hai-long;GUAN Guo-ping;YIN Jian;GE Yu-qing;LIU Xin-hui(Section Ⅱ,Dept of Orthopaedics,Nanjing Jiangning Hospital,Nanjing,Jiangsu 211100,China)

机构地区：[1]南京市江宁医院骨2科,江苏南京211100

出　　处：《临床骨科杂志》2020年第6期866-869,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨后内侧联合前外侧入路治疗胫骨后外侧平台骨折的疗效。方法采用后内侧联合前外侧入路复位固定治疗46例胫骨后外侧平台骨折患者。术后采用Rasmussen放射学评分评价胫骨平台骨折复位情况,末次随访时采用膝关节功能Rasmussen评分对患膝进行功能评定。结果患者均获得随访,时间12~25个月。骨折均一期愈合,时间12~19周。术后无切口感染及骨折畸形愈合发生,摄X线片复查显示无螺钉松动、钢板断裂,无后外侧关节面高度丢失的情况发生。术后骨折复位情况:Rasmussen放射学评分为16~18分,其中优38例,良8例。胫骨平台内翻角、后倾角术后即刻至术后12个月不同时间点比较差异均无统计学意义(P>0.05)。术后1年膝关节功能Rasmussen评分19~29分,其中优23例,良19例,可4例,优良率为91.3%。结论胫骨后外侧平台骨折通过后内侧联合前外侧入路进行复位固定,具有暴露清楚、固定可靠、临床疗效好等优点。Objective To explore the clinical efficacy of posterolateral tibial plateau fractures treated with posteromedial and anterolateral approaches.Methods The 46 patients with posterolateral tibial plateau fractures were treated by the posteromedial and anterolateral approaches.The reduction condition of tibial plateau were evaluated by the Rasmussen radiographic score,the effected knee function was evaluated by the Rasmussen knee function score at the last follow-up.Results All patients were followed up for 12~25 months.All fractures were healed in one stage,the time was 12~19 weeks.No varus deformity and deep wound infection occurred after the surgery.The X-ray reexamination showed that there was no screw loosening and plate fracture,no posterolateral articular surface height loss occurred.The postoperative reduction condition:Rasmussen radiology score was 16~18 points,the result was excellent in 38 cases,good in 8.The varus angle and the posterior slope angle of the tibial plateau showed that there were no significant differences at any period from the immediately postoperation to 12 months postoperation,respectively(P>0.05).At postoperative 1 year,Rasmussen knee joint function score was 19~29 points,the result was excellent in 23 cases,good in 19,fair 4,with the excellent-good rate of 91.3%.Conclusions Posteromedial and anterolateral approaches can facilitate the reduction and fixation for posterolateral tibial plateau fracture,which has many advantages such as good exposure,firm fixation and the excellent clinical result.

关 键 词：胫骨骨折 骨折内固定 内 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]