不同手术入路治疗胫骨平台骨折80例临床分析

Clinic analysis of different surgical approach in the treatment of 80 cases of tibial plateau fracture

目的探讨不同手术入路治疗胫骨平台骨折的临床效果。方法 80例胫骨平台骨折患者根据入路方式的不同分为治疗组与对照组各40例,两组都采用锁定钢板内固定治疗,对照组手术入路为"S"形传统切口,治疗组手术切口位于膝关节后外侧。结果治疗组患肢膝关节HSS评分值明显高于对照组(P<0.05),表明其膝关节功能恢复更好。两组手术时间、手术出血量和住院时间对比,差异无统计学意义(P>0.05),治疗组的并发症发生率明显少于对照组(P<0.05)。结论经膝关节后外侧入路锁定钢板内固定治疗胫骨平台骨折大都可以实现充分、直接的显露,方便在直视下复位、固定,创伤少,恢复快,值得临床推广应用。

Objective To investigate the clinical effects of different surgical approach in the treatment of tibial plateau fractures. Methods Eighty cases of tibial plateau fractures were equally divided into treatment group and control group according to the different way of approach, both groups were treated by the locking plate fixation, the surgical ap- proach of control group was ＂S＂ shaped traditional incision, and the surgical incision of treatment group was from pos terolateral knee. Results The limb HSS score of treatment group was significantly higher than that in control group （P 〈 0.05）. And operation time, blood loss and hospital stay of two groups compared, the difference was not significant （P 〉 0.05）, but the complication rate of treatment group was significantly less than that of control group （P 〈 0.05）. Con- clusion Locked knee posterolateral plate fixation in treatment of tibial plateau fractures can achieve mostly full, direct exposure, it is convenient for reset, fixation under direct vision, with less trauma, quicker recovery, it is worthy of clin- ical application.