Comparison of the Efficacy of Two Different Combined Approaches for Open Reduction and Internal Fixation in the Treatment of Complex Tibial Plateau Fractures
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.
Complex tibial plateau fracturesCombined approach internal fixationKnee joint function
万方数据
维普
