膝前正中入路与内外侧双切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨折的临床疗效比较

Clinical Effect Comparison of Anterior Median Knee Approach and Medial-lateral Double Incision Approach for Treatment of Schatzker Type V and TypeⅥTibial Plateau Fractures

目的比较膝前正中入路与内外侧双切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨折的临床效果。方法便利选取2022年1月—2023年12月涟水县第三人民医院收治的62例SchatzkerⅤ型、Ⅵ型胫骨平台骨折患者为研究对象,以随机数表法分为对照组和研究组,每组31例。两组患者均接受钢板固定治疗,对照组采用内外侧双切口入路,研究组采用膝前正中入路,比较两组各项围术期指标、膝关节恢复效果、并发症发生情况。结果两组骨折愈合时间、膝关节恢复效果、并发症总发生率对比,差异无统计学意义(P均>0.05)。研究组平均手术时长(91.58±16.52)min短于对照组,平均术中出血量(295.67±36.75)mL少于对照组,差异有统计学意义(t=2.537、3.528,P均<0.05)。结论膝前正中入路与内外侧双切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨折均有良好的治疗效果,但膝前正中入路的手术时间更短、术中出血量更低,可显著缓解患者术后疼痛。

Objective To compare the clinical effects of anterior median knee approach and medial-lateral double incision approach in the treatment of Schatzker type V and typeⅥtibial plateau fractures.Methods 62 patients with Schatzker type V and typeⅥtibial plateau fracture admitted to Lianshui County Third People's Hospital from January 2022 to December 2023 were conveniently selected as the study objects and were divided the control group and the study group by random number table method,with 31 cases in each group.Both of them were treated with plate fixation,the control group used medial-lateral double incision approach,and the study group used anterior median knee approach.Perioperative indexes,knee joint recovery effects,and the occurrence of complications were compared between the two groups.Results There were no statistically significant difference between the fracture healing time,knee joint recovery effect,and total complication rate in the two groups(all P>0.05).The average duration of surgery in the study group(91.58±16.52)min was shorter than that in the control group,and the average intraoperative bleeding(295.67±36.75)mL was less than that in the control group,the differences were statistically significant(t=2.537,3.528,both P<0.05).Conclusion Both anterior median knee approach and medial-lateral double incision approach have good therapeutic effects in the treatment of Schatzker type V and typeⅥtibial plateau fracture.But the anterior median knee approach has a shorter operative time,lower intraoperative bleeding,and can significantly alleviate the patient's postoperative pain.