改良前外侧切口结合竹筏螺钉技术治疗累及后外侧平台的胫骨平台骨折(1)
[摘要] 目的 觀察改良前外侧切口结合竹筏螺钉技术治疗累及后外侧平台的胫骨平台骨折疗效。方法 方便选取该院(2017年1月—2018年12月)收治累及后外侧平台的胫骨平台骨折患者60例，以随机数字法分成对照组(30例)与治疗组(30例)，对照组患者采用传统前外侧入路胫骨近端锁定加压钢板固定治疗，治疗组采取改良前外侧切口结合竹筏螺钉技术治疗，并在术后进行12个月的随访。对照两组患者术后即刻、术后1、3、6、12月术后胫骨平台的内翻角及后倾角的变化及Rasmussen膝关节功能评分及术后并发症发生情况。结果 术后即刻两组患者胫骨平台的内翻角及后倾角指标及Rasmussen评分比较，差异无统计学意义(P>0.05)，在术后1、3、6、12个月治疗组患者胫骨平台的内翻角及后倾角低于对照组，Rasmussen评分高于对照组，差异有统计学意义(P<0.05)。且治疗组患者术后并发症发生率为0.00%少于对照组并发症发生率16.67%，差异有统计学意义(χ2=5.455，P<0.05)。结论 在累及后外侧平台的胫骨平台骨折患者的治疗中，以改良前外侧切口结合竹筏螺钉技术治疗，可明显减少胫骨平台的内翻角及后倾角水平，改善膝关节功能，降低并发症的发生，效果理想。
[关键词] 改良前外侧切口;竹筏螺钉技术;手术治疗;累及后外侧平台;胫骨平台骨折
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2020)07(c)-0092-03
[Abstract] Objective Observe the effectof modified anterolateral incision combined with bamboo raft screw technique to treat tibial plateau fractures involving the posterolateral plateau. Methods Sixty patients with tibial plateau fractures involving the posterolateral platform were treated in the hospital (January 2017 to December 2018) and were convenient selection divided into a control group (30 cases) and a treatment group (30 cases) by random number method. Traditional anterior-lateral approach tibial locking compression plate fixation was used. The treatment group was treated with a modified anterior-lateral incision combined with bamboo raft screw technique， and a follow-up of 12 months was performed postoperatively. The changes of the varus angle and posterior tilt angle of the tibial plateau， Rasmussen knee function score and postoperative complications in the two groups of patients immediately after operation， 1， 3， 6， and 12 months after operation. Results Immediately after operation， the varus， anteversion angle and Rasmussen scores of the tibial plateaus of the two groups were compared， and there was no statistically significant difference (P>0.05). The tibial plateaus of the treatment group were 1， 3， 6， and 12 months of the varus and anteversion fingers were lower than the control group， the Rasmnssen score was higher than control group，the difference was statistically significant (P<0.05). The incidence of postoperative complications in the treatment group was 0.00% less than that in the control group， 16.67%， the difference was statistically significant (χ2=5.455， P<0.05). Conclusion In the treatment of patients with tibial plateau fractures involving the posterolateral platform， the modified anterolateral incision combined with bamboo raft screw technology can significantly reduce the level of varus and anteversion angle of the tibial plateau， improve knee function， and reduce complications occurrence， the effect is ideal., 百拇医药(何洪武 庄华伟 欧阳玉斌 房辉强 万富贵)
[关键词] 改良前外侧切口;竹筏螺钉技术;手术治疗;累及后外侧平台;胫骨平台骨折
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2020)07(c)-0092-03
[Abstract] Objective Observe the effectof modified anterolateral incision combined with bamboo raft screw technique to treat tibial plateau fractures involving the posterolateral plateau. Methods Sixty patients with tibial plateau fractures involving the posterolateral platform were treated in the hospital (January 2017 to December 2018) and were convenient selection divided into a control group (30 cases) and a treatment group (30 cases) by random number method. Traditional anterior-lateral approach tibial locking compression plate fixation was used. The treatment group was treated with a modified anterior-lateral incision combined with bamboo raft screw technique， and a follow-up of 12 months was performed postoperatively. The changes of the varus angle and posterior tilt angle of the tibial plateau， Rasmussen knee function score and postoperative complications in the two groups of patients immediately after operation， 1， 3， 6， and 12 months after operation. Results Immediately after operation， the varus， anteversion angle and Rasmussen scores of the tibial plateaus of the two groups were compared， and there was no statistically significant difference (P>0.05). The tibial plateaus of the treatment group were 1， 3， 6， and 12 months of the varus and anteversion fingers were lower than the control group， the Rasmnssen score was higher than control group，the difference was statistically significant (P<0.05). The incidence of postoperative complications in the treatment group was 0.00% less than that in the control group， 16.67%， the difference was statistically significant (χ2=5.455， P<0.05). Conclusion In the treatment of patients with tibial plateau fractures involving the posterolateral platform， the modified anterolateral incision combined with bamboo raft screw technology can significantly reduce the level of varus and anteversion angle of the tibial plateau， improve knee function， and reduce complications occurrence， the effect is ideal., 百拇医药(何洪武 庄华伟 欧阳玉斌 房辉强 万富贵)