后内侧联合前外侧入路治疗胫骨平台骨折

Posteromedial Plus Anterolateral Approaches for Tibial Plateau Fractures

目的探讨后内侧联合前外侧入路治疗胫骨平台骨折的早期临床疗效。方法方便选取2010年3月—2014年9月该院收治54例复杂胫骨平台骨折,采用后内侧倒＂L＂形联合前外侧手术入路行骨折复位钢板内固定,依照美国特种外科医院（Hospital for special surgery,HSS）膝关节评分系统行评定末次随访时的疗效。结果术后随访14-21个月,平均16.5个月;HSS评分：优31例,良15例,中6例,差2例,优良率85.2%。术后无深部感染,无内固定物松动折断及复位丢失。结论后内侧联合前外侧切口治疗复杂胫骨平台骨折,能充分显露手术野,坚强内固定,软组织并发症少,膝关节功能恢复满意。

Objective To investigate the early clinical efficacy of Posteromedial plus anterolateral approaches for the treatment of Tibial Plateau Fractures.Methods Convenient selection from march 2010 to September 2014,54 cases of complex fractures of tibial plateau were treated in our department.They were treated with internal fixation using posteromedial plus anterolateral approaches.Hospital for Special Surgery Knee Score（HSS） was adopted to evaluate patients＇ knee function.Results All cases were followed up for 14 to 21 months（average,16.5 months）. HSS score： excellent 31 cases,good 15 cases,medium 6 cases,poor 2 case, fine rate was 85.2%.No deep infection and no loosing or breakage of the internal fixation occurred in the group.Conclusion Posteromedial plus anterolateral approaches allow satisfied visualization of the tibial plateau and stable fixation with low complication occurrence for the treatment of complex tibial plateau fractures. The function of knee was satisfied.