两种后外侧手术入路治疗Schatzker Ⅱ型胫骨平台骨折的疗效比较
摘要
目的比较侧"L"形入路与后外侧长弧形双肌间隙入路治疗后外侧胫骨平台骨折的临床疗效。方法32例接受治疗的胫骨平台后外侧骨折患者分为对照组(后外侧倒"L"形入路)18例和观察组(后外侧长弧形双肌间隙入路)14例。评估两组手术时间、失血量、引流量、愈合时间、住院时间、疼痛评分等指标。结果观察组手术时间、失血量、术后引流量较对照组少,差异有统计学意义(P<0.05)。愈合时间和住院时间方面两组差异无统计学意义(P>0.05)。术后30、90天观察组HSS评分明显高于对照组,VAS评分明显低于对照组,差异有统计学意义(均P<0.05)。术后180天,两组在HSS功能评分及VAS评分方面差异无统计学意义(均P>0.05)。两组复位满意率及并发症发生率差异均无统计学意义(均P>0.05)。结论后外侧倒"L"形入路治疗后外侧胫骨平台骨折较为安全,且术后近期(术后3个月)疗效(膝关节功能和疼痛方面)显著。
引文
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[3]Dai Z,Jafarzadeh SR,Niu J,et al. Body Mass Index Mediates the Association between Dietary Fiber and Symptomatic Knee Osteoarthritis in the Osteoarthritis Initiative and the Framingham Osteoarthritis Study.J Nutr,2018,148(12):1961
[4]刘雅克,陶然,王洪,等.胫骨平台骨折术后膝关节创伤性关节炎风险预测模型的构建.中华骨科杂志,2016,36(18):1160
[5]Heidari N,Lidder S,Grechenig W,et al.The risk of injury to the anterior tibial artery in the posterolateral approach to the tibia plateau:a cadaver study. J Orthop Trauma,2013,27(4):221
[6]Sun H,Luo CF,Yang G,et al.Anatomical evaluation of the modified posterolateral approach for posterolateral tibial plateau fracture. Eur J Orthop Surg Traumatol,2013,23(7):809
[7]Tao J,Hang DH,Q G,et al.The posterolateral shearing tibial plateau fracture:treatment and results via a modified posterolateral approach. Knee,2008,15(6):473
[8]He X,Ye P,Hu Y,et al.A posterior inverted L-shaped approach for the treatment of posterior bicondylar tibial plateau fractures.Arch Orthop Trauma Surg,2013,133(1):23