经内侧入路治疗胫骨平台后内侧骨折的疗效分析

The value of medial approach in the treatment of posterior medial tibial fractures

目的：探讨经内侧入路治疗胫骨平台后内侧骨折的临床疗效。方法60例胫骨平台后内侧骨折患者按照数字表法分为观察组和对照组，观察组实施内侧入路手术，对照组实施后内侧入路手术，比较两组临床效果。结果观察组手术时间为（138．4＆#177;18．2）min，对照组为（119．2＆#177;15．8）min，两组差异有统计学意义（t ＝4．363，P ＜0．01）；观察组康复优良率为96．7％，显著高于对照组的83．3％（Z ＝2．237，P ＜0．05）；观察组骨折愈合时间（14．5＆#177;3．3）周，显著短于对照组的（17．9＆#177;3．6）周（t ＝3．813，P ＜0．01）；两组住院时间和并发症发生率差异均无统计学意义（均 P ＞0．05）。结论经内侧入路治疗胫骨平台后内侧骨折的损伤相对较小，固定牢靠，能提高康复效果，是值得临床考虑的手术入路途径之一。

Objective To investigate the clinical value of medial approach in the treatment of posterior tibial plateau fractures.Methods 60 cases with posterior tibial plateau fractures were randomly divided into observation group and control group.The observation group was operated by medial approach,and the control group was operated by medial approach.Results The operation time of the observation group was （138.4 ＆#177;18.2）min,which of the con-trol group was （119.2 ＆#177;15.8）min,the difference between the two groups was statistically significant（t =4.363,P ＆lt;0.01）.The excellent and good rate of rehabilitation in the observation group was 96.7%,which was significantly higher than 83.3% of the control group （Z =2.237,P ＆lt;0.05）.The fracture healing time of the observation group was （14.5 ＆#177;3.3）weeks,which was significantly shorter than （17.9 ＆#177;3.6）weeks of the control group （t =3.813, P ＆lt;0.01）.The hospitalization time and incidence rate of complications had no statistically significant differences between the two groups （P ＆gt;0.05）.Conclusion The medial approach in the treatment of the posterior tibial plateau fractures has relatively small injury,reliable fixation,and good rehabilitation.It is one of surgical approaches which worthy of clinical consideration.