前外侧Gerdy结节截骨复位固定胫骨外侧平台骨折  

Anterolateral Gerdy tubercle osteotomy for reduction and fixation of lateral tibial plateau fractures

作　　者：李钧 李徽[1] 汪志群 程飞 LI Jun;LI Hui;WANG Zhi-qun;CHENG Fei(Department of Traumatic Orthopaedics,People's Hospital of Huangshan,Huangshan 245000,China)

机构地区：[1]黄山市人民医院创伤骨科,安徽黄山245000

出　　处：《中国矫形外科杂志》2024年第20期1905-1908,共4页Orthopedic Journal of China

摘　　要：[目的]探讨前外侧Gerdy结节截骨入路复位固定胫骨平台外侧髁塌陷性骨折的临床疗效。[方法]2020年1月—2022年3月采用前外侧Gerdy结节截骨入路复位固定胫骨平台外侧髁塌陷性骨折73例。评价临床与影像学资料。[结果]73例患者均顺利完成手术,术中无严重并发症。随访时间平均(15.4±3.9)个月,随着自术前,术后3个月和末次随访的时间推移,HSS评分[(26.1±5.2),(80.6±4.1),(89.4±3.2),P<0.001]、VAS评分[(8.5±0.8),(1.3±0.4),(0.3±0.1),P<0.001]、膝ROM[(3.1±0.4)°,(120.4±4.7)°,(132.3±5.6)°,P<0.001]均显著改善。影像方面,胫骨近端内侧角(medial proximal tibial angle,MPTA)[(89.3±1.0)°,(86.2±1.6)°,(86.1±1.5)°,P<0.001]、胫骨平台后倾角(posterior tibial slope,PTS)[(9.0±0.8)°,(6.3±0.9)°,(6.2±0.8)°,P<0.001]及Rasmussen评分[(5.1±0.7),(17.4±0.4),(17.5±0.4),P<0.001]均显著改善。至末次随访,所有患者均无骨不连、内固定松动断裂。[结论]采用前外侧Gerdy结节截骨入路复位固定胫骨平台外侧髁塌陷性骨折,可同时显露外侧柱及后外侧柱,软组织损伤小,操作简便,短期疗效满意。[Objective]To investigate the clinical outcomes of anterolateral Gerdy tubercle osteotomy for reduction and fixation of lateral tibial plateau fractures.[Methods]From January 2020 to March 2022,73 patients received the anterolateral Gerdy tubercle osteotomyfor reduction and fixation of the lateral condylar collapsed of tibial plateau fractures.Clinical and imaging data were evaluated.[Results]All the 73 patients successfully completed the operation without serious complications,and followed up for(15.4±3.9)months.As timeelapsed from the point preoperatively to that 3 months postoperatively and the latest follow-up,the HSS score[(26.1±5.2),(80.6±4.1),(89.4±3.2),P<0.001],VAS score[(8.5±0.8),(1.3±0.4),(0.3±0.1),P<0.001],knee ROM[(3.1±0.4)°,(120.4±4.7)°,(132.3±5.6)°,P<0.001]were significantly improved.As for imaging,the medial proximal tibial angle(MPTA)[(89.3±1.0)°,(86.2±1.6)°,(86.1±1.5)°,P<0.001],posterior tibial slope(PTS)[(9.0±0.8)°,(6.3±0.9)°,(6.2±0.8)°,P<0.001]and Rasmussen score[(5.1±0.7),(17.4±0.4),(17.5±0.4),P<0.001]were significantly improved.Up to the last follow-up,all patients had no nonunion,internal fixation loosening and broken.[Conclusion]The anterolateral Gerdy tubercle osteotomy for reduction and fixation of lateral tibial plateau fractures can reveal both lateral and posterolateral columns,with benefits of little soft tissue damage,simple operation and satisfactory short-term efficacy.

关 键 词：前外侧入路 Gerdy结节 截骨 胫骨外侧平台骨折 

分 类 号：R683.42[医药卫生—骨科学]