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后内侧倒“L”形切口三间隙显露联合前外侧入路治疗复杂胫骨平台骨折的临床效果 被引量:20

Clinical effect of posteromedial inverted L-shaped incision with anterolateral approach in the treatment of complex tibial plateau fractures
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摘要 目的探讨后内侧倒“L”形切口三间隙显露联合前外侧入路治疗复杂胫骨平台骨折的临床效果。方法以新疆医科大学附属中医医院骨科2013年1月—2017年12月收治的复杂胫骨平台骨折患者76例为研究对象,传统手术组42例采用前外侧入路,男性25例,女性17例;年龄21~58岁,平均37.67岁;致伤原因:道路交通伤23例,外力伤10例,坠落伤9例;受伤至手术时间(6.8±0.8)d。联合入路组34例采用后内侧倒“L”形切口三间隙显露联合前外侧入路,男性20例,女性14例;年龄19~55岁,平均35.91岁;致伤原因:道路交通伤19例,外力伤10例,坠落伤5例;受伤至手术时间(6.5±0.9)d。记录两组患者手术时长、术中出血量、术后并发症发生率、住院时间、Rasmussen评分及膝关节功能评估。结果传统手术组患者手术时长及住院时间[(148.29±12.17)min、(9.54±2.06)d]均长于联合入路组[(115.63±10.88)min、(7.23±1.24)d],差异有统计学意义(P<0.05);术中出血量与联合入路组患者的差异无统计学意义(P>0.05);传统手术组患者Rasmussen评分(72.34±6.72)分低于联合入路组(78.86±7.12)分,差异有统计学意义(P<0.05);传统手术组术后并发症发生率(16.67%)高于联合入路组(8.82%),差异有统计学意义(P<0.05);传统手术组术后12个月HSS评分(11.74±2.18)分低于联合入路组(14.08±1.06)分,差异有统计学意义(P<0.05)。结论后内侧倒“L”形切口三间隙显露联合前外侧入路治疗复杂胫骨平台骨折可改善预后,恢复膝关节功能,临床优势明显。 Objective To investigate the clinical effect of posteromedial inverted L-shaped incision with anterolateral approach in the treatment of complex tibial plateau fractures.Methods Totally 76 patients with complex tibial plateau fractures who admitted to our hospital from Jan.2013 to Dec.2017 were analyzed,including 42 patients in the traditional operation group and 34 patients in the combined treatment group.There were 25 males and 17 females in the traditional operation group,with an average age of 37.67 years (range,21-58 years).There were 23 cases of traffic accidents,10 cases of traumatic injuries and 9 cases of falling injuries.The time from injury to operation was (6.8±0.8) days.In the combined treatment group,34 cases were treated with posteromedial inverted L-shaped incision,including 20 males and 14 females.Their age ranged from 19 to 55 years,with an average age of 35.91 years.There were 19 cases of traffic accidents,10 cases of traumatic injuries and 5 cases of falling injuries.And the time from injury to operation was (6.5±0.9) days.The operative time,intraoperative blood loss,the incidence of surgical complications,Rasmussen score and HSS score were recorded.Results The operation time and hospitalization time [(148.29±12.17)min,(9.54±2.06)d]of the traditional operation group were longer than those of the combined approach group[(115.63±10.88)min,(7.23±1.24)d,P <0.05].There was no significant difference in intraoperative bleeding volume between the traditional operation group and the combined approach group( P >0.05).Rasmussen score was lower than that of the combined approach group(72.34±6.72 vs.78.86±7.12)( P <0.05).The incidence of postoperative complications was higher than that of the combined approach group(16.67% vs.8.82%)( P <0.05).HSS score was lower than that of the combined approach group(11.74±2.18 vs.14.08±1.06)( P <0.05).Conclusion The posteromedial inverted L-shaped incision combined with anterior lateral approach for the treatment of complex tibial plateau fractures can improve
作者 吴迎波 刘鹏程 王广东 王洪波 乔为民 闫涛 WU Ying-bo;LIU Peng-cheng;WANG Guang-dong;WANG Hong-bo;QIAO Wei-min;YAN Tao(Department of Orthopaedic,The Affiliated Chinese Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处 《创伤外科杂志》 2019年第7期519-522,共4页 Journal of Traumatic Surgery
关键词 胫骨平台骨折 切口 入路 内固定 tibial plateau fracture incision approach internal fixation
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