后外侧倒“L”形入路治疗胫骨平台后外侧骨折的疗效观察

Therapeutic efficacy observation on posterolateral reversed “L”shaped approach for posterolateral tibial plateau fractures

目的探讨后外侧倒＂L＂形入路治疗胫骨平台后外侧骨折的疗效及体会。方法笔者自2010年1月～2013年8月对24例胫骨平台后外侧骨折采用后外侧倒＂L＂形入路行切开复位钢板内固定术,男性17例,女性7例;年龄21～62岁,平均43岁。左侧14例,右侧10例。致伤原因：道路交通伤13例,高处坠落伤11例。患者术前行膝关节正侧位X线片、CT平扫加三维重建,部分行膝关节MRI检查。结果24例均获得随访6～29个月,平均16.9个月。末次随访时采用美国膝关节外科学会（HSS）评分评定膝关节功能：优18例,良4例,可2例;优良率91.67%。全部骨折均获得骨性愈合,至末次随访时无创伤性关节炎发生,膝关节活动度100°～130°。结论采用后外侧倒＂L＂形切口治疗累及胫骨平台后外侧骨折的临床效果优良。

Objective To investigate the therapeutic efficacy and experience on posterolateral reversed“L” shaped approach for posterolateral tibial plateau fractures.Methods From Jan.2010 to Aug.2013,24 cases of posterolateral tibial plateau fractures in our hospital were treated with posterolateral reversed“L” shaped approach and plate fixation.Seveteen cases were male and 7 cases were female with an average age of 43 years（21-62 year）. Fractures occurred on the left side in 14 cases and right side in 10 cases.Thirteen cases were from traffic accident and 11 were from falling.All patients underwent X ray and CT scan combined with three-dimensional reconstruction and some cases underwent MRI examination.Results All patients were followed up for 6-29 months with an aver-age of 16.9 months.In the last follow-up,all cases were evaluated with HSS score system to assess the knee func-tion.Excellent results were found in 18 cases,good in 4 cases and fair in 2 cases,and the excellent and good rate was 91.67%.All fractures were healed without traumatic arthritis in the last follow-up and the angle of knee activi-ty was 100 ＆#176;-130 ＆#176;. Conclusion Excellent clinical results are gained while using posterollateral reversed “L”shaped approach in the treatment of posterolateral tibial plateau fractures.