改良髌旁内侧入路治疗胫骨平台后内侧骨折的疗效分析

Curative effect analysis on improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture

目的探讨改良髌旁内侧入路治疗胫骨平台后内侧骨折的临床疗效。方法选取2014年6月至2017年6月本院收治的胫骨平台后内侧骨折(PMF-TP)患者60例,依据手术方法分为改良组和内侧组,每组30例。内侧组给予常规内侧入路手术治疗;改良组给予改良髌旁内侧入路手术治疗,比较2组手术、并发症、骨折复位、膝关节功能等情况。结果改良组术中出血量、并发症发生率、手术时间、住院时间、负重锻炼时间、骨折愈合时间明显低于内侧组,2组比较差异有统计学意义(P<0.05);改良组术后6个月膝关节屈曲、伸展活动度明显高于内侧组,2组比较差异有统计学意义(P<0.05);改良组术后6个月骨折复位、膝关节功能优良率明显高于内侧组,2组比较差异有统计学意义(P<0.05)。结论与膝关节后内侧入路比较,改良髌旁内侧入路手术具有操作简单、安全性高等优势,有利于患者早期功能锻炼及骨折复位、膝关节功能恢复。

Objective To discuss the clinical effects of improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture（ PMF-TP）. Methods 60 patients with PMF-TP were selected from June 2014 to June 2017 in our hospital; according to the surgical methods,all patients were divided into improved group（ 30 cases） and medial group（ 30 cases）; the medial group was treated with routine medial approach,while the improved group was treated with improved medial parapatellar approach. The operation,complications,fracture reduction and knee joint function were compared between the two groups. The amount of bleeding,the incidence of complications and the operation,hospitalization,weight bearing exercise and fracture healing time of improved group were significantly low er than those in themedial group,the difference was statistically significant（ P〈0. 05）. 6 months after the operation,the knee flexion and extensional activity of improved group was significantly higher than that in the medial group,the difference was statistically significant（ P 〈0. 05）. The fracture reduction and knee joint function excellent rate 6 months after operation of improved group were significantly higher than those in the medial group,the difference was statistically significant（ P 〈0. 05）. Results Compared with the posteromedial approach of the knee joint,the improved medial parapatellar approach features simple and safe operation. It is beneficial to early functional exercise,fracture reduction and rehabilitation of knee joint function.