[1]王 磊,周业金,姚 涛,等.腓骨颈截骨入路与后外侧入路治疗后外侧胫骨平台骨折的效果[J].医学信息,2020,33(24):89-92.[doi:10.3969/j.issn.1006-1959.2020.24.024]
　WANG Lei,ZHOU Ye-jin,YAO Tao,et al.The Effect of Fibular Neck Osteotomy and Posterolateral Approach in the Treatment of Posterolateral Tibial Plateau Fractures[J].Medical Information,2020,33(24):89-92.[doi:10.3969/j.issn.1006-1959.2020.24.024]
点击复制

腓骨颈截骨入路与后外侧入路治疗后外侧胫骨平台骨折的效果()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年24期
页码:
89-92
栏目:
论著
出版日期:
2020-12-15

文章信息/Info

Title:
The Effect of Fibular Neck Osteotomy and Posterolateral Approach in the Treatment of Posterolateral Tibial Plateau Fractures
文章编号:
1006-1959（2020）24-0089-04
作者:
王 磊; 周业金; 姚 涛; 陶 勇
安徽医科大学第三附属医院创伤骨科，安徽 合肥 230001
Author(s):
WANG Lei; ZHOU Ye-jin; YAO Tao; TAO Yong
Department of Traumatology and Orthopedics,the Third Affiliated Hospital of Anhui Medical University,Hefei 230001,Anhui,China
关键词:
胫骨平台; 腓骨颈截骨入路; 后外侧入路; 解剖复位
Keywords:
Tbial plateau; Fibular neck osteotomy approach; Posterolateral approach; Anatomical reduction
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2020.24.024
文献标志码:
A
摘要:
目的 探讨腓骨颈截骨入路与后外侧入路治疗后外侧胫骨平台骨折的临床疗效。方法 回顾性分析2017年8月~2020年5月我院收治的胫骨平台后外侧骨折患者43例，根据手术入路方式不同分为腓骨颈截骨组（20例）和后外侧入路组（23例），比较两组手术时间、术中出血量、术后并发症情况及术后膝关节功能评分、Rasmussen评分。结果 两组手术时间、术中出血量、术后第3个月膝关节Lyscholm功能评分比较，差异无统计学意义（P＞0.05）；腓骨颈截骨入路组术后第3个月后外侧骨折复位Rasmussen评分高于后外侧入路组[（17.53±0.52）分vs（16.63±1.35）分]，差异有统计学意义（P＜0.05）；腓骨颈截骨入路组术后并发症发生率低于后外侧入路组，差异有统计学意义（P＜0.05）。结论 腓骨颈截骨入路与后外侧入路均可有效治疗后外侧胫骨平台骨折，但腓骨颈截骨入路可以获得更好的复位效果并减少术后并发症，值得临床应用。
Abstract:
Objective To investigate the clinical effects of the fibular neck osteotomy and posterolateral approach in the treatment of posterolateral tibial plateau fractures.Methods Retrospective analysis was performed on 43 patients with posterolateral tibial plateau fracture admitted to our hospital from August 2017 to May 2020. According to different surgical approaches, they were divided into the fibular neck osteotomy approach group (20 cases) and the posterolateral approach group (23 cases).The operation time, intraoperative blood loss, postoperative complications, postoperative knee function score and Rasmussen score were compared between the two groups.Results There was no significant difference in operation time, intraoperative blood loss, and Lyscholm function scores of the knee joint at the third month after the operation between the two groups (P>0.05); the fibular neck osteotomy group had a posterior lateral fracture at the third month after the operation the Rasmussen score of reduction was higher than that of the posterolateral approach group [(17.53±0.52) points vs (16.63±1.35) points], the difference was statistically significant (P<0.05);The incidence of postoperative complications in the fibular neck osteotomy group was lower than that in the posterolateral approach group,the difference was statistically significant (P<0.05).Conclusion Both the fibular neck osteotomy approach and the posterolateral approach can effectively treat posterolateral tibial plateau fractures, but the fibular neck osteotomy approach can achieve better reduction effects and reduce postoperative complications, and is worthy of clinical application.

参考文献/References:

[1]Galla M,Lobenhoffer P.The direct,dorsal approach to the treatment of unstable tibial posteromedial fracture-dislocations[J].Der Unfallchirurg,2003,106(3):241-247. [2]Gavaskar AS,Gopalan H,Tummala NC,et al.The extended posterolateral approach for split depression lateral tibial plateau fractures extending into the posterior column:2 years follow up results of a prospective study[J].Injury,2016,47(7):1497-1500. [3]Cheng T,Xia RG,Dong SK,et al.Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries:A Retrospective Comparative Study[J].Journal of Investigative Surgery,2019,32(3):245-254. [4]Rasmussen PS.Tibial condylar fractures impairment of knee joint stability as an indication for surgical tre atment[J].J Bone Joint Surg Am,1973,55(7):1331-1350. [5]张世民,李海丰,黄轶刚.骨折分类与功能评定[M].北京:人民军医出版社,2008:203-204. [6]张彬彬.胫骨平台“新三柱理念”损伤机制可信度及基于损伤机制胫骨平台骨折三维形态学研究[D].上海交通大学,2019. [7]张道鑫,韩庆斌,徐留海,等.跟骨关节内骨折术中不植骨的安全性及疗效[J].创伤外科杂志,2018,20(6):79-80. [8]Honkonen SE.Indications for surgical treatment of tibial condyle fractures[J].Clin Orthop Relat Res,1994(302):199-205. [9]Chang SM,Zheng HP,Li HF,et al.Treeatment of isolated posterior coronal fracture of the lateral tibial plateau through posterolateral approach for direct exposure and buttress plate fixation[J].Arch Orthop Trauma Surg,2009,129(7):955-962. [10]胡孙君,张世民,张英琪,等.胫骨平台后外侧象限骨折手术入路的深层解剖及后外侧与后内侧比较[J].中国临床解剖学杂志,2015,33(5):497-500.

相似文献/References:

[1]邢学武,姜文学.胫骨平台后内侧骨折的治疗现状[J].医学信息,2020,33(13):46.[doi:10.3969/j.issn.1006-1959.2020.13.013]
　XING Xue-wu,JIANG Wen-xue.Treatment Status of Posterior Medial Fracture of Tibial Plateau[J].Medical Information,2020,33(24):46.[doi:10.3969/j.issn.1006-1959.2020.13.013]
[2]付佳男.关节镜辅助下治疗SchatzkerⅠ~Ⅳ型胫骨平台骨折的疗效[J].医学信息,2022,35(20):87.[doi:10.3969/j.issn.1006-1959.2022.20.022]
　FU Jia-nan.Effect of Arthroscopic Assisted Treatment of Schatzker Ⅰ-Ⅳ Tibial Plateau Fracture[J].Medical Information,2022,35(24):87.[doi:10.3969/j.issn.1006-1959.2022.20.022]

更新日期/Last Update: 1900-01-01