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三种固定方式治疗单纯胫骨平台后外侧骨折的疗效分析
Hits: 2728   Download times: 1395   Received:June 20, 2017    
作者Author单位UnitE-Mail
徐龙 XU Long 湖州市中医院骨伤科, 浙江 湖州 313000 Department of Orthopaedics Chinese Medicine, Huzhou 313000, Zhejiang, China  
王宝虎 WANG Bao-hu 湖州市中医院骨伤科, 浙江 湖州 313000 Department of Orthopaedics Chinese Medicine, Huzhou 313000, Zhejiang, China 13757288926@139.com 
林清宇 LIN Qing-yu 湖州市中医院骨伤科, 浙江 湖州 313000 Department of Orthopaedics Chinese Medicine, Huzhou 313000, Zhejiang, China  
张占丰 ZHANG Zhan-feng 湖州第一人民医院, 浙江 湖州 313000 Traumatology, Huzhou Hospital of Traditional Chinese Medicine, Huzhou 313000, Zhejiang, China  
期刊信息:《中国骨伤》2017年30卷,第10期,第885-890页
DOI:10.3969/j.issn.1003-0034.2017.10.002
基金项目:浙江省医药卫生一般计划(编号:2014KYA206)。


目的:分析比较传统前外侧入路、外侧入路和后外侧入路3种方式固定治疗胫骨平台后外侧骨折的优缺点及其疗效。

方法:2010年5月至2014年7月收治胫骨平台后外侧骨折病例44例,男21例,女23例;年龄26~61岁,平均42.5岁。根据不同手术入路方式将所有病例分为3组,前外侧入路组(A组)19例,外侧入路组(B组)15例,后外侧入路组(C组)10例。比较3组患者的手术时间及出血量,术后随访观察膝关节功能,评估方式采用HSS评分。

结果:前外侧入路组平均手术时间(91.3±10.4) min,术中出血量(175.3±20.3) ml;外侧入路组平均手术时间(86.6±9.2) min,术中出血量(155.8±18.2) ml;后外侧入路组平均手术时间(109.5±10.8) min,术中出血量(235.9±29.1) ml.后外侧入路组手术时间及术中出血量与前外侧入路组、外侧入路组相比差异有统计学意义(P<0.05).随访时间10~35个月,平均14.9个月。末次随访时HSS评分前外侧入路组89.6±7.5,外侧入路组90.2±6.4,后外侧入路组88.9±5.1,3组相比差异无统计学意义(P>0.05).

结论:胫骨平台后外侧骨折的治疗可以使用多种方式进行暴露固定,3种方式中,后外侧入路手术时间和术中出血量高于其余2种方式,在短期随访的膝关节功能方面三者并没有明显区别。
[关键词]:胫骨平台骨折  骨折固定术,内  外科手术
 
Analysis of the treatment of posterolateral tibial plateau fracture with three different methods
Abstract:

Objective:To analyze and compare the efficacy of surgical approaches and fixations of anterolateral approach,lateral approach and posterolateral approach in treating posterolateral tibial plateau fracture.

Methods:A retrospective study of 44 cases from May 2010 to July 2014 were enrolled,of which there were 21 males and 23 females,and the mean age was 42.5 years old (ranged,26 to 61 years). All the cases were divided into 3 groups according to the surgical approach,group A was anterolateral approach (19 cases),group B was lateral approach (15 cases),group C was posterolateral approach (10 cases). Operative time and bleeding volum were compared and the knee function was observed.

Results:The mean operative time of group A was (91.3±10.4) min,and the bleeding volum of which was (175.3±20.3) ml. The mean operative time of group B was(86.6±9.2) min,and the bleeding volum of which was(155.8±18.2) ml. The mean operative time of group C was (109.5±10.8) min,and the bleeding volum of which was(235.9±29.1) ml. There were significant differences in operative time and bleeding volum between group C and the other two groups(P<0.05). The mean follow-up time was 14.9 months (ranged,10 to 35 months),and the HSS score of last follow-up was 89.6±7.5 (group A),90.2±6.4(group B),88.9±5.1 (group C). There were no significant differences in groups(P>0.05).

Conclusion:The operative time of posterolateral approach was longer than anterolateral approach or lateral approach,as well as the bleeding volum which was higher in posterolateral approach,while no significant difference of the knee function was observed in these 3 different approaches.
KEYWORDS:Tibial plateau fracture  Fracture fixation,internal  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:徐龙,王宝虎,林清宇,张占丰.三种固定方式治疗单纯胫骨平台后外侧骨折的疗效分析[J].中国骨伤,2017,30(10):885~890
英文格式:XU Long,WANG Bao-hu,LIN Qing-yu,ZHANG Zhan-feng.Analysis of the treatment of posterolateral tibial plateau fracture with three different methods[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(10):885~890
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