前后联合小切口入路治疗复杂胫骨平台伴后髁骨折临床探析

目的比较传统前侧入路手术与前后联合小切口入路治疗复杂胫骨平台伴后髁骨折的临床疗效。方法选择该院2010年3月—2013年3月收治的80例患者,患者临床诊断为复杂胫骨平台伴后髁骨折,按照数字表格法将患者随机分为两组,对照组采用传统前侧入路手术治疗,观察组采用前后联合小切口入路治疗,术后6个月比较两组患者的膝关节功能评分并观察两组患者的术后并发症。结果观察组治疗后膝关节功能总分为（72.25±10.56）分高于对照组（60.29±9.43）分,两组治疗效果差异有统计学意义（P〈0.05）;观察组并发症12例,对照组21例,差异有统计学意义（P〈0.05）。结论前后联合小切口入路治疗复杂胫骨平台伴后髁骨折比传统前侧入路手术可以更有效的提高患者膝关节功能,减少术后并发症,值得在临床上大力推广。

Clinical Analysis of the Treatment of Complex Tibial Plateau with Posterior Condylar Fracture by Combined Anterior and Posterior Approach via Small Incision

Objective To compare the clinical effect between the traditional anterior approach surgery and combined anterior and posterior approach via small incision for the treatment of complex tibial plateau with posterior condylar fracture. Methods 80 cases clinically diagnosed with complex tibial plateau complicated by posterior condylar fracture and treated in our hospital from March 2010 to March 2013 were selected and randomly divided into two groups, the control group and the observation group, according to the digital table method. The control group was treated by conventional anterior approach surgery, and the observation group was treated by combined anterior and posterior approach via small incision. 6 months after operation, the knee function score was compared between the two groups and the postoperative complications of the groups were observed. Results After treatment, the total knee function score of the observation group was 72.25±10.56 points, higher than 60.29±9.43 points of the control group, the difference in treatment effect between the two groups was statistically significant （P〈0.05）; complications occurred in 12 cases in the observation group, and 21 cases in the control group, the difference was statistically significant （P〈0.05）. Conclusion For complex tibial plateau with posterior condylar fracture, combined anterior and posterior approach via small incision can improve the knee function more significantly with less complications compared with conventional anterior approach surgery, so it is worthy of clinical promotion vigorously.