后外侧入路钢板内固定治疗胫骨后外侧髁骨折的效果分析  

The Effect of Posterolateral Approach Plate Internal Fixation in the Treatment of Posterolateral Condyle Fracture of Tibia

作　　者：张道前[1] 邵卫东[1] 周业松[1] 刘开祥[2] ZHANG Daoqian;SHAO Weidong;ZHOU Yesong;LIU Kaixiang(Department of Orthopedics,The First Affiliated Hospital of Huai'an First People's Hospital,Huai'an 223000,China;Department of Orthopedics,Huai'an First People's Hospital,Huai'an 223000,China)

机构地区：[1]江苏省淮安市第一人民医院一分院骨科,江苏省淮安市223000 [2]江苏省淮安市第一人民医院骨科,江苏省淮安市223000

出　　处：《组织工程与重建外科杂志》2020年第6期498-500,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探索后外侧入路钢板内固定治疗胫骨后外侧髁骨折的效果。方法 2015年4月至2018年3月,共70例胫骨后外侧髁骨折患者,随机分为实验组和对照组,每组35例。对照组采用膝关节后正中入路,实验组采用后外侧入路,比较两组患者的临床疗效以及预后情况。两组患者术后均随访12个月。结果两组患者在术后住院时间、手术时间、术中失血量和术后引流量上无明显差异(P>0.05)。实验组骨折平均愈合时间(6.6±1.2)个月,对照组为(8.2±2.4)个月,差异显著(P<0.05)。HSS评分比较,实验组为85.5±2.3,明显高于对照组的74.2±3.5(P<0.05)。Rasmussen放射学评分,实验组为17.1±0.3,明显高于对照组的14.6±0.5(P<0.05)。两组患者切口均甲级愈合,无明显感染、皮肤坏死以及内固定断裂等不良情况发生。结论相比后正中入路,后外侧入路钢板内固定治疗胫骨后外侧髁骨折效果更优,值得临床推广。Objective To investigate the clinical effect of posterolateral approach plate internal fixation in the treatment of posterolateral condyle fracture of tibia.Methods Seventy patients with posterolateral condyle fracture of tibia treated from April 2015 to March 2018 were selected and divided into experimental group(n=35)and control group(n=35)according to the random number table method.In the experimental group,the posterolateral approach was adopted,while the posterior median approach was adopted in the control group.The clinical efficacy and prognosis of the two groups were compared.The patients were followed up for 12 months.Results There were no significant differences in the length of postoperative hospital stay,operation time,intraoperative blood loss,and postoperative drainage between the two groups(P>0.05).The fracture healing time in the experimental group was(6.6±1.2)months,while that of the control group was(8.2±2.4)months,with significant difference(P<0.05).The HSS score of the experimental group was 85.5±2.3,which was significantly higher than that of the control group(74.2±3.5,P<0.05).The Rasmussen radiological score of the experimental group was 17.1±0.3,which was significantly higher than that of the control group(14.6±0.5,P<0.05).The incisions of patients in both groups were healed at the first grade without obvious infection,skin necrosis or rupture of internal fixation.Conclusion Compared with the posterior median approach,posterolateral approach plate internal fixation for the treatment of posterolateral tibial condylar fracture is more effective,which is worthy of clinical promotion.

关 键 词：胫骨后外侧髁骨骨折 内固定术 后外侧入路 

分 类 号：R683.4[医药卫生—骨科学]