侧后方入路治疗胫骨平台后方剪切骨折的临床效果观察The clinical observation of posteromedial and posterolateral approaches in the treatment of posterior shearing tibial plateau fractures
孙启彬;王玉;孟庆军;于庆才;
摘要(Abstract):
[目的]探讨侧后方入路治疗胫骨平台后方剪切骨折的临床效果。[方法]回顾分析2009年1月~2012年4月收治的46例行侧后方入路治疗的胫骨平台后方剪切骨折患者的临床资料,后内侧入路经由半腱肌、半膜肌和腓肠肌内侧头间隙,后外侧入路自腘肌和比目鱼肌间隙,骨折块直视下复位后采用"T"型支撑钢板固定。术后随访观察固定效果及临床疗效。[结果]患者均获随访,时间12~32个月[(22±0.3)个月]。所有患者均未发生术区皮肤坏死、感染或内固定松动等手术并发症。影像学评估:术后即刻和术后1年的后倾角、内翻角的差异均无统计学意义(P>0.05)。末次随访HSS临床功能评分平均87.6分,依据Rasmussen标准评价临床疗效:优27例(58.7%)、良13例(28.3%)、可6例(13.0%)。[结论]侧后方入路可充分暴露胫骨后平台,降低前方入路广泛剥离导致的软组织并发症,直视下复位关节面固定牢靠,患者术后膝关节功能良好,是较好的手术治疗策略。
关键词(KeyWords): 胫骨平台后方骨折;后方入路;钢板固定;膝关节功能;疗效
基金项目(Foundation):
作者(Author): 孙启彬;王玉;孟庆军;于庆才;
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DOI:
参考文献(References):
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