侧后方入路治疗胫骨平台后髁骨折17例

目的探讨膝关节侧后方入路治疗胫骨平台后髁骨折的手术效果。方法对2004-01～2009．06收治的17例胫骨平台后髁骨折患者采用后内侧和后外侧人路治疗，评价其内固定方式和术后临床疗效。结果17例患者均获随访，时间为13～21（15．3±2）个月。患者膝关节功能评定按Hohl评分标准，优13例，良4例。复查x线片骨折复位良好，关节面未见明显塌陷及内外翻情况。结论经后外侧或后内侧入路可充分暴露胫骨平台后髁，减少前方入路大范围剥离所带来的软组织并发症，直视下骨折块可以获得良好复位和牢固固定，充分防止力线的改变和骨折的再移位，有利于患者良好的膝关节功能恢复。

Treatment of posterior condylar fractures of tibial plateau by posterolateral approach

Objective To investigate the operation effect of the treatment of posterior condylar fractures of tibial plateau by posterolateral approach. Methods From January 2004 to June 2009, 17 patients with posterior con- dylar fractures of tibial plateau were treated by internal fixation operation through the anteromedial and posterolateral approach in our hospital and their postoperative clinical curative effect was evaluated. Results All patients were fol- lowed up for 13 ~21 months, with an average of mean （15.3 ~2）months. Patients＇ knee function was evaluated ac- cording to the Hohl standard. The results showed excellent in 13 patients, good in 4 patients. The review of X-ray film showed good fracture reduction, no obvious collapse and inversion of articular surface. Conclusion The posteromedi- al or posterolateral approach can fully expose the posterior tibial condyle, reduce the complications, due to wide range of stripping the soft tissue though anterior approach, obtain good reduction and rigid fixation of fracture block under direct vision, fully prevent force line change and fracture displacement, and is beneficial to patients with good func- tional recovery of knee joint.