联合入路手术治疗胫骨平台骨折

Combined surgical approaches in the treatment of tibial plateau fractures

目的探讨后内侧倒L形切口联合前外侧入路手术治疗胫骨平台骨折的临床疗效。方法采用后内侧倒L形切口联合前外侧入路手术治疗30例胫骨平台骨折患者。术后对膝关节功能HSS评分和胫骨平台内翻角、后倾角进行评价分析。结果30例均获得随访,时间12~15个月。骨折均愈合,时间13~22周。术后1例出现切口感染,经清创换药后痊愈。患者术后12个月胫骨平台内翻角及后倾角均恢复良好,膝关节HSS评分为74~96分,优良率为93.3%。结论联合入路手术治疗胫骨平台骨折可以精确复位和足量植骨以及坚强内固定,有利于膝关节早期功能锻炼,并发症少,临床疗效满意。

Objective To investigate the clinical efficacy of posteromedial inverted L-shape approach combined anterolateral approach for the treatment of tibial plateau fractures.Methods The posteromedial inverted L-shape approach combined with the anterolateral approach in the treatment of tibial plateau fractures were performed in 30 cases.The varus angle,posterior slope of the tibial plateau and HSS scores were used to evaluate the knee joint function.Results All the patients were followed up for 12~15 months.All the fractures were healed.The healing time ranged from 13 weeks to 22 weeks.One case with incision infection occurred after operation,the patient recovered after debridement and dressing change.Tibial plateau varus angle and posterior slope both recovered well,and HSS score was 74~96 points with the excellent-good rate of 93.3%at 12 months after operation.Conclusions Combined surgical approaches for the treatment of tibial plateau fractures can repair articular surface fracture exactly,implant enough bone graft into the collapse of the tibial plateau,and realize the firm fixation.Therefore,these advantages are beneficial to the early functional exercise,with fewer complications and satisfactory effect.