双切口入路联合双接骨板固定治疗前外侧合并后外侧胫骨平台骨折的效果

Effect of Double Incision Approach Combined with Double Bone Plate Fixation in the Treatment of Anterolateral and Posterolateral Tibial Plateau Fractures

目的:探讨双切口入路(前外侧+后内侧)联合双接骨板固定治疗前外侧合并后外侧胫骨平台骨折的效果。方法:选取2018年2月-2022年1月信宜市人民医院收治的66例前外侧合并后外侧胫骨平台骨折患者,采用随机数字表法分为观察组和对照组,各33例。对照组给予前外侧入路手术治疗,观察组给予双切口入路(前外侧+后内侧)联合双接骨板固定治疗,比较两组患者手术情况、术前及术后6个月膝关节功能、并发症发生情况。结果:观察组手术时间、骨折愈合时间均较对照组显著缩短,术中出血量少于对照组,差异均有统计学意义(P<0.05)。术前两组患者膝关节功能(疼痛、行走能力、伸膝滞缺程度、关节活动度、关节稳定性、总分)评分比较,差异均无统计学意义(P>0.05);术后6个月两组患者膝关节功能评分均显著提高,且观察组患者膝关节功能评分提高均更显著,差异均有统计学意义(P<0.05)。观察组并发症发生率为6.06%,低于对照组24.24%,差异有统计学意义(P<0.05)。结论:双切口入路联合双接骨板固定可促进前外侧合并后外侧胫骨平台骨折患者骨折愈合及膝关节功能恢复,减少并发症。

Objective:To investigate the effect of double incision approach(anterolateral+posterior medial)combined with double bone plate fixation in the treatment of anterolateral and posterolateral tibial plateau fractures.Method:Sixty-six patients with anterolateral and posterolateral tibial plateau fractures admitted to Xinyi People's Hospital from February 2018 to January 2022 were selected,they were divided into observation group and control group by random number table method,with 33 cases in each group.The control group was treated with anterolateral approach surgery,and the observation group was treated with double incision approach(anterolateral+posterior medial)combined with double plate fixation.The operation status,knee function before surgery and 6 months after surgery,and the incidence of complications were compared between the two groups.Result:The surgery time and fracture healing time of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in knee function(pain,walking ability,degree of knee extension stagnation,range of motion,joint stability and total score)between the two groups(P>0.05);6 months after surgery,knee function scores in both groups were significantly improved,and the improvement in the observation group were more significant,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 6.06%,lower than 24.24%in the control group,the difference was statistically significant(P<0.05).Conclusion:Double incision approach combined with double bone plate fixation can promote fracture healing and knee functional recovery in patients with anterolateral tibial plateau fracture combined with posterolateral tibial plateau fracture,and reduce complications.