改良后外侧直切口入路治疗胫骨后外侧平台骨折的疗效及影像学评价被引量：13

Treatment Effect and Imaging Evaluation of Modified Posterolateral Straight Incision Approach in Treatment of Posterolateral Tibial Plateau Fractures

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摘要目的探讨改良后外侧直切口入路治疗胫骨后外侧平台骨折的疗效及影像学评价.方法选取60例后外侧胫骨平台骨折患者,收集患者术后1 a膝关节功能评分(HSS评分)、末次随访的膝关节活动度(ROM)、术后即刻、3个月、1 a的胫股角(FTA)、胫骨平台内翻角(TPA)和外侧胫骨后倾角(PA).结果随访12-16个月,60例患者均达到骨折愈合标准,平均骨折愈合时间(13.82±0.75)周.随访中无感染、骨折移位、内固定失效、螺钉断裂、骨不连或畸形等并发症.末次随访HSS评分(94.01±1.30)分;术后即刻FTA,TPA,PA分别为(175.48±6.96)°,(83.44±4.29)°,(8.55±0.22)°;术后3个月FTA,TPA,PA分别为(175.68±7.22)°,(83.62±4.09)°,(8.58±0.19)°;术后1 a FTA,TPA,PA分别为(175.27±6.91)°,(83.34±4.65)°,(8.53±0.18)°.结论改良后外侧直切口入路在治疗胫骨后外侧平台骨折的过程中可充分显露术野,同时能很好地保护腘动脉、腓总神经及周围软组织. Objective To investigate the effect and imaging evaluation of modified posterolateral straight incision approach in the treatment of posterolateral tibial plateau fractures. Method Sixty patients with posterolateral tibial plateau fractures were selected. General data of the patients were collected. The knee function score( HSS score) and the knee range of motion( ROM) at the last follow-up were evaluated one year after operation. The tibial plateau varus angle( TPA),Tibiofemoral angle and lateral tibial posterior slope angle( PA) were measured immediately,3 months and 1 year after operation. Results The follow-up time of 60 patients ranged from 12 to16 months. All the 60 patients met the fracture healing standard. The average healing time was( 13. 82 ±0. 75)weeks. No complications such as infection,fracture displacement,internal fixation failure,screw fracture,nonunion or deformity were found during follow-up. HSS score at the last follow-up was( 94. 01 ±1. 30). Immediately after operation,FTA,TPA and PA were( 175. 48 ± 6. 9 6) °,( 83. 44 ± 4. 29) °,( 8. 55 ± 0. 22) °,respectively. Three months after operation,FTA,TPA and PA were( 175. 68 ± 7. 22) °,( 83. 62 ± 4. 09) °,( 8. 58 ± 0. 19) °,respectively. One year after operation,FTA,TPA and PA were( 175. 27 ±6. 91) °,( 83. 34 ±4. 65) °,( 8. 53 ±0. 18) °,respectively. Conclusion The modified posterolateral straight incision approach can fully expose the operative field and protect the popliteal artery,common peroneal nerve and surrounding soft tissue in the treatment of posterolateral tibial plateau fracture. However,further research is needed to confirm its superiority.

作者方兴 FANG Xing(2nd People’s Hospital in Hefei City,Hefei 230011,China)

机构地区合肥市第二人民医院

出处《北华大学学报（自然科学版）》 CAS 2020年第1期66-69,共4页 Journal of Beihua University（Natural Science）

基金安徽省教育厅科学研究项目(AHS201816kj)

关键词胫骨平台骨折后外侧入路改良 tibial plateau fracture posterolateral approach modifyied

分类号 R681.8 [医药卫生—骨科学]

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参考文献1

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