不同入路切开复位内固定治疗后外侧胫骨平台骨折疗效对比
Comparison of Clinical Efficacy of Open Reduction and Internal Fixation in Different Approaches for the Treatment of Posterolateral Fracture of Tibial Plateau
丁佶康 1赵斌1
作者信息
- 1. 225400 江苏 泰州,泰兴市中医院骨科
- 折叠
摘要
目的 对比分析不同入路切开复位内固定治疗后外侧胫骨平台骨折(FTP)的临床效果.方法 选取 2019 年 1 月至 2022 年 1 月泰兴市中医院收治的 52 例后外侧FTP患者作为研究对象,按照不同手术入路方式将其分为后外侧组(26 例)和后内侧组(26 例),后外侧组患者采用膝关节后外侧入路切开复位内固定治疗,后内侧组患者采用膝关节后内侧入路切开复位内固定治疗,对比观察两组患者围手术期相关指标、膝关节活动度、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)及并发症发生情况.结果 后外侧组患者手术时间、住院时间均明显短于后内侧组(t=19.632、6.483,P均＜0.001),术中出血量明显少于后内侧组(t=17.649,P＜0.001);术后 6 个月,后外侧组患者膝关节伸直、屈曲活动度均明显大于后内侧组(t=3.072、2.249,P=0.003、0.029),WOMAC中的日常生活、疼痛、关节僵硬评分及总分均明显低于后内侧组(t=7.123、6.249、3.899、6.504,P均＜0.001).后外侧组患者术后并发症发生率为 7.69%,与后内侧组患者的术后并发症发生率11.54%无明显差异(χ2=0.221,P=0.638).结论 与膝关节后内侧入路切开复位内固定相比,膝关节后外侧入路切开复位内固定治疗后外侧FTP的手术时间及患者术后恢复时间更短,临床疗效更佳,更有利于患者膝关节功能的恢复.
Abstract
Objective To compare the clinical efficacy of open reduction and internal fixation(ORIF)in different approaches for the treatment of posterolateral fracture of tibial plateau(FTP).Methods 52 patients with posterolateral FTP,admitted into Taixing City Hospital of Traditional Chinese Medicine from January 2019 to January 2022,were enrolled as research subjects and divided into the posterolateral group(n=26)and the posteromedial group(n=26)based on the different surgical approaches they received.The patients in the posterolateral group were treated with ORIF through the posterolateral knee approach,while the patients in the posteromedial group were treated with ORIF through the posteromedial knee approach.The perioperative related indicators,knee joint range of motion,Western Ontario and McMaster Universities osteoarthritis index(WOMAC),and occurrence of complications were compared between the two groups.Results The operation time and the length of stay are significantly shorter in the posterolateral group compared with the posteromedial group(t=19.632 and 6.483,both P＜0.001),and the intraoperative blood loss was also significantly less in the posterolat-eral group(t=17.649,P＜0.001).Six months after surgery,the knee joint extension and flexion ranges of motion were significantly larger in the posterolateral group compared with the posteromedial group(t=3.072 and 2.249,P=0.003 and 0.029),WOMAC scores for daily living,pain,joint stiffness,and total score were significantly lower in the posterolateral group(t=7.123,6.249,3.899 and 6.504,all P＜0.001).The incidence of postoperative complications was 7.69%in the posterolateral group,showing no significant difference compared with the 11.54%in the posteromedial group(χ2=0.221,P=0.638).Conclusion Compared with the ORIF posteromedial knee approach,the ORIF posterolateral knee approach for posterolateral FTP can realize shorter operation time and postoperative recovery time,much better clinical efficacy,and is more conducive for the recovery of the patients'knee joint function.
关键词
后外侧胫骨平台骨折/手术入路方式/膝关节活动度/膝关节功能/并发症Key words
Posterolateral fracture of tibial plateau/Surgical approach/Knee joint range of motion/Knee joint function/Complication引用本文复制引用
出版年
2024
NETL
NSTL
万方数据