摘要
目的:比较前外侧联合后内侧倒“L”形入路与前正中联合后侧“S”形入路切开复位内固定治疗复杂胫骨平台骨折的临床效果。方法:选择2019年6月—2023年4月新乡医学院第一附属医院收治的96例复杂胫骨平台骨折患者,将其随机分为两组,各48例。两组均行切开复位内固定术治疗,观察组采取前外侧联合后内侧倒“L”形入路,对照组采取前正中联合后侧“S”形入路。比较两组围手术期指标、Rasmussen放射评分、Rasmussen功能评分。结果:两组住院时间、骨折愈合时间比较,差异均无统计学意义(P>0.05);观察组手术时间短于对照组,术中出血量少于对照组(P<0.05)。术后即刻及术后12个月,两组Rasmussen放射评分比较,差异均无统计学意义(P>0.05)。术后3、6、12个月,观察组Rasmussen功能评分明显高于对照组(P<0.05)。不同时间Rasmussen功能评分比较,差异有统计学意义(F时间=916.076,P时间<0.01),组间Rasmussen功能评分比较,差异有统计学意义(F组间=15.589,P组间<0.01),时间和组间存在交互作用(F交互=43.211,P交互<0.01)。结论:与前正中联合后侧“S”形入路相比,前外侧联合后内侧倒“L”形入路切开复位固定治疗复杂胫骨平台骨折具有手术视野清晰、软组织损伤小、术后功能良好等优点。
Objective:To compare the clinical efficacy of anterolateral combined posterolateral inverted"L"shape approach and anterior median combined with posterior"S"shape approach in open reduction and internal fixation of complex tibial plateau fracture.Method:A total of 96 patients with complex tibial plateau fracture admitted to the First Affiliated Hospital of Xinxiang Medical College from June 2019 to April 2023 were randomly divided into two groups,with 48 patients in each group.Both groups were treated with open reduction and internal fixation.The observation group was treated with anterolateral and posterolateral inverted"L"shape approach,while the control group was treated with anterior median combined with posterior"S"shape approach.Perioperative indexes,Rasmussen radiological scores and Rasmussen functional scores were compared between the two groups.Result:There were no significant differences in hospitalization time and fracture healing time between the two groups(P>0.05).The surgery time of observation group was shorter than that of control group,and the amount of blood loss during surgery was less than that of control group(P<0.05).Immediately after surgery and 12 months after surgery,there were no significant differences in Rasmussen radiological scores between the two groups(P>0.05).At 3,6 and 12 months after surgery,the Rasmussen function scores of the observation group were significantly higher than those of the control group(P<0.05).The comparison of Rasmussen functional scores at different times showed statistically significant differences(Ftime=916.076,Ptime<0.01),and the comparison of Rasmussen functional scores between groups showed statistically significant differences(Fgroup=15.589,Pgroup<0.01),there was an interaction between time and groups(Finteraction=43.211,Pinteraction<0.01).Conclusion:Compared with the anterior median combined with posterior"S"shape approach,the anterolateral and posterolateral inverted"L"shape approach for open reduction and internal fixation in the treatment of complex tibial plateau fractures has the advantages of clear visual field,less soft tissue damage and better postoperative function.
作者
程晋涛
董玉珍
CHENG Jintao;DONG Yuzhen(Second Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,China)
出处
《中国医学创新》
CAS
2024年第35期105-109,共5页
Medical Innovation of China
关键词
复杂胫骨平台骨折
联合入路内固定术
膝关节功能
Complex tibial plateau fractures
Combined approach internal fixation
Knee joint function
