【摘要】 目的评价膝前正中切口在治疗复杂胫骨平台骨折的疗效。方法回顾性分析收治的39例三柱的复杂胫骨平台骨折患者。17例患者采用前正中+后内侧切口(A组),22例采用前外侧+后内侧切口(B组)。比较两组患者手术时间、术中出血量、骨折愈合时间、感染率,以及术后1年膝关节功能评分、膝关节屈曲活动度和术后平片,评估手术效果。结果 A组在手术时间(t=-8.445,P<0.001)和术中出血量(t=-6.367,P<0.001)上优于B组,差异有统计学意义;在骨折愈合时间(t=0.472,P=0.640)和感染率(P=1.000)上,A组和B组差异无统计学意义;在膝关节功能上,膝关节功能优良率(P=1.000)和膝关节屈曲(t=-0.177,P=0.860),A组和B组间的差异无统计学意义;患者放射学评估的内翻角度(t=-0.212,P=0.834)、后倾角度(t=-0.280,P=0.782)、Rasmussen放射学评分(t=0.656,P=0.516)对比,两组间的差异无统计学意义。结论在治疗复杂胫骨平台骨折中,前正中+后内侧切口在是值得推荐的。更多还原

【Abstract】 Objective To evaluate the efficacy of anterior midline approach on the treatment of complex tibial plateau fractures. Methods A retrospective review of 39 complex tibial plateau fractures was performed. Among them, 17 patients received operation using anterior midline plus posteromedial approach(Group A), while 22 patients using Anterolateral plus posteromedial approach(Group B). They were followed for minimum of 12 months. Operative time, peri-operative blood loss, healing time of fracture, infection rate, knee functional score of 1 year later, range of motion, and postoperative X-ray were included for comparison. Results There were significant differences in operative time(t=-8.445, P<0.001) and peri-operative blood loss(t=-6.367, P<0.001) between the two groups; but no significant difference was proved in healing time of fracture(t=0.472, P=0.640), infection rate(P=1.000), excellent and good rate of knee function score(P=1.000), range of motion(t=-0.177, P=0.860),varus angulations(t=-0.212, P=0.834), posterior slop(t=-0.280, P=0.782) or Rasmussen score(t=0.656, P=0.516) between the two groups. Conclusion Based on our findings, the anterior midline plus posteromedial approach is suggested for complex tibial plateau fractures.更多还原