胫骨平台骨折术后后倾角对膝关节功能的影响  

Effect of posterior tibial slope on knee joint function after tibial plateau fracture surgery

作　　者：吴兴净 陶周善 程文静 Wu Xingjing;Tao Zhoushan;Cheng Wenjing(Dept of Orthopedics,Yijishan Hospital,Wannan Medical College,Wuhu 241000)

机构地区：[1]皖南医学院弋矶山医院骨科,芜湖241000

出　　处：《安徽医科大学学报》2024年第9期1659-1663,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金项目(编号:82002322);2021年度芜湖市科技计划项目(编号:2021yf62)。

摘　　要：目的探讨胫骨平台骨折术后后倾角的改变以及其与膝关节功能的关系。方法收集83例行-胫骨平台骨折手术的病例,测出患者健侧、术后患侧及最后一次随访患侧胫骨平台后倾角(PTS),评价并记录Lysholm、HSS及Rasmussen等三种系统的膝关节评分数据,根据术后PTS角度将患者分为PTS<9°组和PTS≥9°组。将两组三种膝关节功能评分均数行统计学分析,同时也将术后与最后随访PTS均数进行统计学处理。计算最后随访与健侧PTS的差值,将差值与最后一次随访膝关节功能数据进行相关性分析。结果两组患者一般情况方面未见明显差异。PTS<9°组膝关节Lysholm、HSS、Rasmussen评分数据均明显高于PTS≥9°组(P<0.05)。两组患者术后PTS与最后一次随访PTS相比,差异有统计学意义(P<0.05)。最后一次随访与健侧PTS之间的差值(b)与Lysholm、HSS及Rasmussen膝关节评分数据均具有相关性(P<0.05)。结论术后康复锻炼导致PTS角度发生改变。PTS<9°组患者膝关节功能好于术后PTS≥9°组患者,最后一次随访PTS与健侧PTS的差值与膝关节功能有相关性。因此手术中尽可能恢复平台骨折的解剖对位或控制术后PTS<9°。Objective To explore the changes in posterior tibial slope after tibial plateau fracture surgery and its relationship with knee joint function.Methods The cases of 83 patients who underwent tibial plateau fracture surgery were collected.The posterior tibial slope(PTS)of the patient's unaffected side,the affected side after surgery and the affected side at the last follow-up were measured.He knee joint score data of Lysholm,HSS and Rasmussen were evaluated and recorded,and the patients were divided into PTS<9°group and PTS≥9°group according to the PTS angle after operation.The mean of three kinds of knee joint function scores in the two groups were statistically analyzed,and the mean of PTS after operation and final follow-up was also statistically processed.The difference of PTS between the last follow-up and the healthy side was calculated,and the correlation between the difference and the knee joint function data at the last follow-up was analyzed.Results There was no significant difference in general conditions between the two groups of patients.The Lysholm,HSS,and Rasmussen score data of knee joints in PTS<9°group were significantly higher than those in the PTS≥9°group(P<0.05).There was a significant difference in postoperative PTS between the two groups of patients compared to the last follow-up PTS(P<0.05).The difference between the last follow-up and the PTS of the unaffected side(b)was correlated with Lysholm,HSS and Rasmussen knee score data(P<0.05).Conclusion Postoperative rehabilitation exercise leads to changes in the angle of PTS.The knee joint function of patients in PTS<9°group is better than that of patients in group PTS≥9°after surgery.The difference between the last follow-up PTS and the healthy side PTS is correlated with knee joint function.Therefore,it is necessary to try to restore the anatomical alignment of the plateau fracture during surgery or control postoperative PTS<9°.

关 键 词：胫骨平台后倾角 胫骨平台骨折 术后 骨折塌陷 膝关节功能评分 相关性 

分 类 号：R683.42[医药卫生—骨科学]