后内侧倒L形辅助前外侧联合入路手术治疗复杂胫骨平台骨折患者的效果及对术后功能恢复的影响

目的探讨后内侧倒L形辅助前外侧联合入路手术治疗复杂胫骨平台骨折患者的效果及对术后功能恢复的影响。方法选择2017年4月至2018年4月在本院接受治疗的复杂胫骨平台骨折患者50例为研究对象,均行后内侧倒L形辅助前外侧联合入路手术治疗。分析患者的治疗效果,比较患者不同时间的骨折复位情况、功能恢复情况。结果 50例患者的手术用时为(1.43±0.21)h,术中出血量为(318.25±3.46)m L,患肢开始负重时间为(13.12±1.24)周,骨折愈合时间为(15.13±1.03)周。患者并发症总发生率为4.00%。术后3、6、12个月,复杂胫骨平台骨折患者PA均大于术后即刻,TPA均小于术后即刻,HSS、膝关节Rasmussen评分均高于术后即刻,且术后时间越长,HSS、膝关节Rasmussen评分越高(P<0.05)。结论后内侧倒L形辅助前外侧联合入路手术治疗复杂胫骨平台骨折患者具有术后恢复快、并发症少、骨折复位与愈合良好的优势,值得临床推广使用。

Effect of posterior medial inverted L-shaped assisted anterior lateral approach in the treatment of patients with complex tibial plateau fracture and its influences on postoperative functional recovery

Objective To investigate the effect of posterior medial inverted L-shaped assisted anterior lateral approach in the treatment of patients with complex tibial plateau fracture and its influences on postoperative functional recovery.Methods Fifty cases of complex tibial plateau fractures patients treated in our hospital from April 2017 to April 2018 were selected as the study objects.All patients were underwent posterior medial inverted L-shaped assisted anterior lateral approach.The therapeutic effects of patients were analyzed,the reduction and functional recovery of fracture at different time were compared.Results In fifty patients,the operation time was(1.43±0.21) h,the intraoperative bleeding volume was(318.25±3.46) mL,the weight-bearing time of the affected limb was(13.12±1.24) weeks and the fracture healing time was(15.13±1.03) weeks,the total incidence of complications was 4.00%.At 3,6 and 12 months after operation,the PA of patients with complex tibial plateau fracture were bigger than those immediately after surgery,and the TPA were smaller than those immediately after surgery,the scores of HSS and Rasmussen of knee joint were higher than those immediately after operation,and the longer the time after operation,the higher the scores of HSS and Rasmussen of knee joint(P<0.05).Conclusion Posterior medial inverted L-shaped assisted anterior lateral approach in the treatment of patients with complex tibial plateau fractures has the advantage of rapid recovery,less complications and good fracture reduction,it is worthy of clinical promotion and application.