复杂胫骨平台骨折两种手术入路的疗效分析

Efficacy Analysis of Two Surgical Approaches for Complex Tibial Plateau Fractures

目的探讨膝正中切口和双切口入路内固定治疗复杂胫骨平台骨折的临床疗效。方法回顾性分析收治的74例复杂胫骨平台骨折患者资料,分别采用膝正中切口(对照组)和双切口入路内固定(观察组)治疗,比较两组骨折复位、愈合程度及膝关节HSS评分。结果内翻角及后倾角方面,治疗后均好于治疗前,组内差异有统计学意义(P<0.05);而组间差异无统计学意义(P>0.05);HSS评分及Rasmussen评分方面,术后两组评分均高于术前,且术后6个月及2年观察组高于对照组,组间和组内差异有统计学意义(P<0.05);对照组出现皮肤延迟愈合4例、切口感染2例,发生率高于观察组(P<0.05)。结论双切口入路治疗复杂胫骨平台骨折对皮肤、软组织血供影响小,可达到准确复位和牢固固定的目的,值得临床推广。

Objective To investigate the knee midline incision and double incision posterior internal fixation for the treatment of complex tibial plateau fractures. Methods In our hospital in January 2011 to 2015 the hospital from June 74 cases of complex tibial plateau fracture patients, were treated with posterior internal fixation in the treatment of knee midline incision and double inci-sion approach, compared two groups of fracture reduction and healing and HSS knee score. Re-sults Before treatment and after treatment two groups of varus angle and angle between group differences had no statistical significance （P〉0.05）, and before and after the treatment group differ-ences have statistical significance （P〈0.05）; two groups of postoperative 6 months and 2 years HSS score and Rasmussen score in the observation group than the control group, group were statisti-cally meter difference （P〈0.05）;in the control group, 4patients had cutaneous delayed healing, inci-sion infection occurred in 2case, was higher than that in the observation group （P〈0.05）.Conclu-sion Double incision approach in the treatment of complex tibial plateau fractures on the skin and soft tissue blood supply, can achieve accurate reduction and fixation of the purpose, it was worthy of clinical promotion.