摘要
Abstract
Objective:To investigate the clinical effect of posteromedial reverse "L" shaped approach combined with anterolateral approach in treatment of complex tibial plateau fractures.Method:A total of 66 patients with complex tibial plateau fractures admitted to our hospital from January to December 2017 were selected.According to the random number table method,they were divided into control group and observation group,33 cases in each group.The control group was treated by anterolateral approach,while observation group was treated by posteromedial reverse "L" shaped approach combined with anterolateral approach.The operation time,intraoperative bleeding volume,fracture healing time,postoperative complications,knee function score and patients' satisfaction between two groups were compared.Result:The operation time,intraoperative bleeding volume and fracture healing time of observation group were less than those of control group,the differences were statistically significant(P<0.05).The incidence of malunion,post-traumatic arthritis,internal fixation loosening or splitting in two groups were compared,the differences were not statistically significant(P>0.05),the incidence of nerve and blood vessel injury in observation group was higher than that of control group(P<0.05).The pain, walking ability,knee extension deficiency,joint mobility,joint stability score and total score of observation group were higher than those of control group,the differences were statistically significant(P<0.05).The total satisfaction rate of control group was 75.76%,which was lower than 93.94% of observation group( x2=4.243, P=0.039).Conclusion:The posteromedial reverse "L" shaped approach combined with anterolateral approach is effective in treatment of complex tibial plateau fractures.It has the advantages of sufficient exposure,firm fixation, short operation time,less bleeding,short healing time,quick recovery of knee joint function and satisfactory treatment.关键词
胫骨平台骨折/后内侧切口/入路方式/临床疗效Key words
Tibial plateau fractures/Posteromedial incision/Approach/Clinical efficacy
