前后联合入路治疗复杂胫骨平台骨折的疗效分析

目的 探讨前后联合入路在治疗复杂胫骨平台骨折的疗效。方法 选取2012 年6 月—2014 年 6 月于上海交通大学医学院附属苏州九龙医院入住的124 例胫骨平台骨折患者，随机分为实验组（行前后联 合入路手术）与对照组（膝前正中入路手术）, 对两组患者的临床疗效进行比较分析。结果 患者均获18 ～ 37 个月随访，平均（24±6）个月；两组患者骨折愈合时间、切口感染及内固定失效比较，差异有统计学意义 （P <0.05）。两组患者日常生活功能、步态、膝关节稳定度、活动范围及Merchant 量表总分比较，差异有统计 学意义（P <0.05）。结论 胫骨平台骨折的手术治疗中，前后联合入路会缩短骨折愈合时间，减少伤口感染及 内固定失效概率，但不能减轻患者疼痛。在术后恢复过程中前后联合入路手术方式要优于膝前正中入路。

Analysis of effect of combined anterior and posterior approach for treatment of complex tibial plateau fractures

Objective To explore the curative effect of combined anterior and posterior approach in the treatment of complex tibial plateau fractures. Methods A total of 124 patients with tibial plateau fractures admitted to Suzhou Kowloon Hospital Affiliated to School of Medicine, Shanghai Jiaotong University from June 2013 to June 2017 were selected and randomly divided into an experimental group (64 cases receiving routine combined anterior and posterior approach operation) and a control group (60 cases undergoing knee anterior median approach surgery). The clinical efficacy of the two groups was compared. Results All 124 patients were followed up for 18- 37 months with an average of (24 ± 6) months. There were significant differences in the average fracture healing time, incision infection and internal fixation failure between the two groups (P < 0.05). The total score of Merchant scale, daily activities, gait, stability of the knee joint and range of activity were significantly different between the two groups (P < 0.05). Conclusions In surgical treatment of tibial plateau fractures, the combined anterior and posterior approach can shorten the healing time of the fracture, reduce the probability of wound infection and internal fixation failure, but can not relieve the pain. In the postoperative recovery process, the combined approach surgery is superior to the knee anterior median approach surgery.