摘要
目的:探讨“V”形逆行截骨结合改良后侧入路治疗胫骨平台后外侧骨折的效果。方法:选取2019年10月—2022年9月鹰潭一八四医院收治的60例胫骨平台后外侧骨折患者,采用随机数字表法分为两组,各30例。对照组采用传统后外侧切开复位治疗,观察组采用“V”形逆行截骨结合改良后侧入路治疗。观察两组手术时间、切口长度、出血量、膝关节功能评分、生活质量、膝关节活动范围、骨折愈合时间、复位情况及并发症发生情况。结果:两组手术时间、切口长度及术中出血量比较,差异均无统计学意义(P>0.05)。术前,两组美国特种外科医院(HSS)膝关节评分、健康调查简表(SF-36)评分比较,差异均无统计学意义(P>0.05);术后12个月,观察组HSS膝关节评分、SF-36评分均高于对照组,差异均有统计学意义(P<0.05)。观察组膝关节活动范围大于对照组,骨折愈合时间短于对照组,差异均有统计学意义(P<0.05)。观察组关节面塌陷、髁部变宽、成角畸形评分均高于对照组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:采用“V”形逆行截骨结合改良后侧入路治疗胫骨平台后外侧骨折的效果更好,具有术后关节功能恢复好、关节活动范围较大、骨折愈合快、复位良好、生活质量高等优势,且并发症较少。
Objective:To investigate the effect of"V"-shaped retrograde osteotomy combined with modified posterior lateral approach in the treatment of posterolateral fracture of tibial plateau.Method:A total of 60 patients with posterolateral fracture of tibial plateau admitted to Yingtan 184 Hospital from October 2019 to September 2022 were selected and divided into two groups by random number table method,with 30 cases in each group.The control group was treated with traditional posterolateral open reduction,and the observation group was treated with"V"-shaped retrograde osteotomy combined with modified posterior lateral approach.Operation time,incision length,blood loss,knee function score,quality of life,knee range of motion,fracture healing time,reduction and complications in the two groups were observed.Result:There were no significant differences in operation time,incision length and intraoperative blood loss between the two groups(P>0.05).Before surgery,there were no significant differences in of hospital for special surgery(HSS)knee joint score and the MOS item short form health survey(SF-36)score between the two groups(P>0.05).At 12 months after surgery,HSS knee joint score and SF-36 score in observation group were higher than those in control group,the differences were statistically significant(P<0.05).The knee joint motion range in observation group was greater than that in control group,and the fracture healing time was shorter than that in control group,the differences were statistically significant(P<0.05).The scores of articular surface collapse,condylar widening and angulation deformity in observation group were higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:The"V"-shaped retrograde osteotomy combined with the modified posterior lateral approach is more effective in the treatment of posterolateral fracture of tibial plateau,which has the advantages of good postoperative joint function recovery,larger joint range of motion,fast fracture healing,good reduction,high quality of life,and fewer complications.
作者
吴刚
汤善华
孙琦
杨俊
WU Gang;TANG Shanhua;SUN Qi;YANG Jun(Department of Orthopedics,Yingtan 184 Hospital,Yingtan 335000,China;不详)
出处
《中国医学创新》
CAS
2024年第34期28-32,共5页
Medical Innovation of China
基金
江西省卫生健康委科技计划项目(SKJP220226073)
2023年度第一批鹰潭市指导性科技计划项目(社发支撑)(2023-9-23212)。
关键词
逆行截骨
关节镜
切开复位
胫骨平台后外侧骨折
膝关节
Retrograde osteotomy
Arthroscopy
Open reduction
Posterolateral fracture of tibial plateau
Knee joint
