扩大前外侧入路治疗胫骨平台后外侧骨折的安全性与有效性分析  

Safety and effectiveness analysis of expanding the anterior lateral approach for the treatment of posterior later⁃al tibial plateau fractures

作　　者：金华 JIN Hua(Department of Emergency Medicine,Taizhou Orthopedic Hospital of Zhejiang Prov-ince,Taizhou 317500,China)

机构地区：[1]浙江省台州骨伤医院急诊科,浙江台州317500

出　　处：《全科医学临床与教育》2024年第11期1001-1004,共4页Clinical Education of General Practice

摘　　要：目的探讨使用扩大前外侧入路治疗胫骨平台后外侧骨折的安全性与有效性。方法选择106例胫骨平台后外侧骨折患者临床资料进行回顾性分析,按照治疗方式不同进行分组,接受扩大前外侧入路内固定治疗的为研究组(56例),接受后外侧入路内固定治疗的为对照组(50例)。比较两组患者的围手术期情况、随访指标和影像学等方面的指标情况。结果研究组患者的手术时间和住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(t分别=9.55、14.71、7.53,P均<0.05)。末次随访时,研究组患者的美国特种外科医院评分(HSS)高于对照组,疼痛视觉模拟评分法(VAS)评分和膝关节各角度主动复位绝对误差角度均低于对照组,差异均有统计学意义(t分别=-7.88、6.88、4.85、5.92、6.73,P均<0.05)。研究组患者的Rasmussen功能优良率高于对照组,差异有统计学意义(χ^(2)=4.78,P<0.05)。结论扩大前外侧入路在胫骨平台后外侧骨折的患者治疗中具操作便捷、安全性高,治疗效果好等优点。Objective To explore the safety and effectiveness of using an expanded anterior lateral approach for the treatment of posterior lateral tibial plateau fractures.Method A retrospective analysis was conducted on 106 patients with posterior lateral tibial plateau fractures,and they were divided into two groups according to different treatment meth⁃ods.The study group(56 cases)received treatment with expanded anterior lateral approach internal fixation,while the control group(50 cases)received treatment with posterior lateral approach internal fixation.The perioperative conditions,follow-up indicators and imaging indicators of the two groups were compared.Results The operative time and hospital stay in the study group were significantly shorter than those in the control group,intraoperative blood was less than that in the control group,with statistical significance(t=9.55,14.71,7.53,P<0.05).At the end of follow-up,the American hospital for special surgery(HSS)score of the study group was higher than that of the control group,the VAS score and the absolute error angle of active knee reduction at all angles were lower than those of the control group,the differences were statistically significant(t=-7.88,6.88,4.85,5.92,6.73,P<0.05).The excellent and good rate of Rasmussen func⁃tion in the study group was higher than that in the control group,and the difference was statistically significant(χ^(2)=4.78,P<0.05).Conclusion The extended anterolateral approach has the advantages of convenient operation,high safety and good therapeutic effect in the treatment of posterolateral fracture of the tibial plateau.

关 键 词：前外侧入路 内固定 胫骨平台骨折 胫骨平台后外侧骨折 

分 类 号：R687.3[医药卫生—骨科学]