腓骨头上入路治疗胫骨平台后外侧骨折的临床研究

Clinical study of the fibula head approach in treatment of lateral tibial plateau fractures

目的 探讨腓骨头上入路治疗胫骨平台后外侧骨折的临床效果。方法 选取我院2010年1月-2014年12月43例胫骨平台后外侧骨折患者进行研究,根据治疗方法不同将43例患者分为试验组（23例患者进行腓骨头上入路治疗）和对照组（20例患者采用传统手术方法）,治疗后随访1年时间,观察患者总有效率、骨折愈合情况、不良反应及预后的膝关节功能HSS评分。结果 试验组的总有效率（95.7%）明显高于对照组（75.0%）,差异有统计学意义（P〈0.05）;试验组患者的骨折愈合率（95.7%）明显高于对照组（70.0%）,差异有统计学意义（P〈0.05）;试验组的不良反应发生率（12.9%）明显低于对照组（55.0%）,差异有统计学意义（P〈0.05）;试验组的膝关节功能HSS评分（92.3±10.2）分明显优于对照组（65.3±10.8）分,差异有统计学意义（P〈0.05）。结论 采用腓骨头上入路治疗胫骨平台后外侧骨折可以提高患者的骨折愈合,安全且功能恢复好。

Objective To explore the clinical effect of the fibula head approach in treatment of lateral tibial plateau fractures. Methods From January 2010 to December 2014, 43 cases of patients with lateral tibial plateau fractures were studied. According to the different treatment methods, 43 patients were divided into experimental group（23 cases of pa- tients were treated with the fibular head approach） and control group （20 patients were treated with traditional surgical method）, patients were followed up for 1 year, the total effective rate, fracture healing, adverse reaction and prognosis of the HSS scores were observed. Results The total efficiency （95.7%） of the experimental group was significantly higher than that of the control group （75.0%）, with significant difference （P〈0.05）; fracture healing rate （95.7%） of the experimental group was significantly higher than that of the control group （70.0%）, with significant difference（P〈0.05）; the adverse reaction incidence rate （12.9%） of the experimental group was significantly lower than the control group （55.0%）, with significant difference（P〈0.05）. The HSS knee score （92.3±10.2） points of experimental group was signifi- cantly better than the control group （65.3±10.8）, with significant difference（P〈0.05）. Conclusion The treatment of frac- tures of the tibial plateau can be imProved by the approach of the upper tibia in the treatment of tibial plateau fractures.