联合入路对复杂胫骨平台骨折术后早期疗效的临床研究  

Clinical study on early postoperative efficacy of combined approach for complex tibial plateau fractures

作　　者：吴志勇 林格生 WU Zhiyong;LIN Gesheng(Wuyi County First People's Hospital,Zhejiang 321200,China)

机构地区：[1]浙江省武义县第一人民医院

出　　处：《浙江创伤外科》2024年第9期1618-1620,1744,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探索联合入路对复杂胫骨平台骨折术后早期疗效的临床效果。方法回顾性纳入2020年1月至2023年8月期间本院收治的72例复杂胫骨平台骨折患者资料,按照不同的手术方式划分为观察组(后内侧联合前外侧入路)和对照组(内外侧双切口双钢板入路)各36例,分析对比其临床资料。结果观察组手术时间(96.57±12.36)min较对照组(79.31±9.62)min长,骨折愈合时间(3.68±0.52)m及住院时间(12.72±1.63)d均较对照组[(4.73±0.61)m、(15.28±1.83)d]短,差异有统计学意义(P<0.05);观察组术中出血量(267.54±45.58)mL低于对照组(320.17±60.82)mL,差异有统计学意义(P<0.05);观察组膝关节活动度(106.49±11.37)°优于对照组(98.27±10.28)°,差异有统计学意义(P<0.05);观察组术后HSS评分(76.81±8.34)优于对照组(70.22±6.91),差异有统计学意义(P<0.05);两组术后胫骨平台内翻角(TPA)和后倾角(PA)比较中无显著差异(P>0.05);观察组术后并发症发生率(2.78%)显著低于对照组(22.22%),差异有统计学意义(P<0.05)。结论后内侧联合前外侧入路在处理复杂的胫骨平台骨折中有显著优势,特别是在解剖重建、减少并发症以及加快恢复过程方面。Objective To explore the clinical efficacy of combined approach in the early postoperative treatment of complex tibial plateau fractures.Methods A retrospective review was conducted on the data of 72 patients with complex tibial plateau fractures admitted to our hospital from January 2020 to August 2023.According to different surgical methods,they were divided into the observation group(posterior medial combined anterior lateral approach)and the control group(internal and external double incision double plate approach),with 36 patients in each group.The clinical data were analyzed and compared.Results The observation group had a longer surgical time(96.57±12.36)min compared to the control group(79.31±9.62)min,and a shorter fracture healing time(3.68±0.52)m and hospital stay(12.72±1.63)d compared to the control group[(4.73±0.61)m、(15.28±1.83)d],with statistically significant differences(P<0.05).The intraoperative bleeding volume in the observation group(267.54±45.58)mL was lower than that in the control group(320.17±60.82)mL,with a significant difference(P<0.05).The range of motion of the knee joint in the observation group(106.49±11.37)°was better than that in the control group(98.27±10.28)°,and the difference was statistically significant(P<0.05).The postoperative HSS score of the observation group(76.81±8.34)was better than that of the control group(70.22±6.91),with a significant dif-ference(P<0.05).There was no significant difference in postoperative TPA and PA between the two groups(P>0.05).There was 1 case of postoperative joint stiffness in the observation group,2 cases of postoperative joint deformity,1 case of traumatic arthritis,2 cases of incision infection,and 3 cases of joint stiffness in the control group.The incidence of postoperative complications in the observation group(2.78%)was significantly lower than that in the control group(22.22%),and the difference was statistically significant(P<0.05).Conclusion The posterior medial combined with anterior lateral approach has significant

关 键 词：胫骨平台骨折 联合入路 关节僵直 并发症 

分 类 号：R687.3[医药卫生—骨科学]