前外侧纵行截骨治疗胫骨后外侧平台塌陷骨折效果分析

Effect of the anterior lateral longitudinal osteotomy in the treatment of posterolateral tibial plateau fracture

目的探讨前外侧截骨手术治疗胫骨平台骨折中后外侧平台塌陷骨折的临床效果。方法对2013年9月至2016年9月收治的30例胫骨后外侧平台塌陷骨折患者,依据随机数字表法分为研究组和对照组各15例。对照组患者行传统后入路切开复位内固定手术治疗,研究组患者经前外侧截骨复位手术治疗。观察2组患者术后X线片并比较2组临床疗效。结果研究组患者在愈合时间、完全负重时间及术后并发症发生率方面均明显优于对照组(P<0.05),但2组患者术后X线片的胫骨平台内翻角及后倾角之间的差异均无统计学意义(P>0.05);研究组患者术后膝关节功能恢复优良率(93%)显著高于对照组(80%)(P<0.05)。结论经前外侧截骨治疗后外侧平台塌陷骨折的临床效果与后入路切开复位内固定手术无明显差别。

Objective To explore the clinical effect of anterior lateral osteotomy in the treatment ot postero- lateral tibial plateau fracture. Methods Thirty patients with posterior tibial plateau fracture who received treat- ment from September 2013 to September 2016 were divided into the study group（n=15）and the control group（n=15） according to random numbers table method. Patients of the control group were treated with traditional posteri- or approach for open reduction and internal fixation, and patients of the study group were treated with anterior lat- eral osteotomous surgery. The X-ray films were observed in the two groups of patients after the operation and the clinical effect was compared. Results Patients of the study group were better than those in control group in the aspects of healing time, full weight bearing time and postoperative complication rates （ P 〈0.05）, but the differ- ences between tibial plateau barus angle and tilt angle in postoperative X-ray film were not significant （ P 〉0.05）. Patients＂ optimal rate of recovery of knee joint function （93 % ） in the study group was significantly higher than that in the control group. （80%） （ P d0.05）. Conclusion The clinical effect of anterior lateral osteosurery in the treatment of fracture of posterior lateral platform of tibial plateau was not significantly different from that of poste- rior approach for open reduction and internal fixation, but the former is superior to the latter in that it reduces postoperative complication rates and has a better postoperative function recovery.