倒“L”切口治疗胫骨平台后柱骨折的疗效分析

Curative effect of the posterior column fractures of tibial plateau treated by posterior reversed L-shaped approach

目的探究倒＂L＂切口治疗胫骨平台后柱骨折的临床疗效。方法选取2012年1月~2014年1月收治的胫骨平台后柱骨折患者21例,男性13例,女性8例;年龄21~69岁。均采取后内侧倒＂L＂形切口入路＋支撑钢板内固定术治疗。回顾性分析患者的临床资料,记录手术相关指标、术后并发症、骨折愈合情况以及膝关节美国特种外科医院（HSS）评分。结果所有患者手术顺利,平均手术时间（162.3±39.2）min,平均术中出血量（176.4±52.0）m L,平均术后住院时间（15.2±4.5）d,平均骨折愈合时间（30.1±7.4）周。术中及术后无严重手术相关并发症。所有患者获得随访,平均随访时间（15.2±4.8）个月,术后12个月平均膝关节HSS评分为（83.5±16.2）,优良率为85.7%（18/21）,术后12个月平均膝关节活动度为（126.5±17.3）°。结论后内侧倒＂L＂形切口入路安全可靠,适用于胫骨平台后柱骨折的治疗。

Objective To explore the curative effect of the posterior column fractures of tibial plateau trea-ted by posterior reversed L-shaped approach .Methods Twenty-one patients with posterior column fractures of tibi-al plateau who were treated with surgeries by posterior reversed L-shaped approach in our hospital from Jan .2012 to Jan.2014 were selected.There were 13 males and 8 females,with age ranging from 21 to 69 years.The clinical data of patients were analyzed retrospectively.Postoperative complications,fracture healing,and American Special Sur-gery Hospital（HSS） scores were recorded.Results All patients were successfully operated.The mean operation time was （ 162.3 ±39.2 ） min;the mean blood loss was （ 176.4 ±52.0 ） mL;the postoperative hospital stay was （15.2 ±4.5）d;and the mean fracture healing time was （30.1 ±7.4）week.There was no severe complication after the surgeries.Patients were followed up for an average of （15.2 ±4.8） months.The mean HSS score was 83.5 ± 16.2 and the excellent rate was 85.7%（ 18/21 ） at 12 months after operation .The mean range of motion was （126.5 ±17.3）°.Conclusion The effect of the posterior column fractures of tibial plateau treated by posterior reversed L-shaped approach is excellent and it is beneficial to expose the fracture end .