经Carlson后外侧入路锁定钢板手术对胫骨平台后外侧骨折的疗效及对关节功能的影响

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摘要目的探讨经Carlson后外侧入路锁定钢板手术对胫骨平台后外侧骨折的疗效及对关节功能的影响。方法选取2017年1月—2020年1月安徽省皖北煤电集团总医院收治的胫骨平台后外侧骨折患者60例，按照随机数字表法将其分为观察组和对照组，每组各30例。观察组给予经Carlson后外侧入路锁定钢板手术，对照组采用传统经后正中入路的锁定钢板手术。比较分析两组术中出血量、骨折显露时间、手术时间、愈合时间、可完全负重时间、并发症发生率及术后6个月膝关节功能Rasmussen评分，并于术后即刻、术后6个月比较两组膝关节胫骨平台后倾角（PA）、内翻角（TPA）变化情况。结果观察组术中出血量明显少于对照组，骨折显露时间明显短于对照组，差异均有统计学意义（均P ＜ 0.05）。两组手术时间、愈合时间及可完全负重时间比较，差异无统计学意义（P ＞ 0.05）；手术后，两组均未出现异物排斥及切口不愈合等并发症；观察组Rasmussen评分优良率明显高于对照组，差异有统计学意义（P ＜ 0.05）；两组术后即刻、术后6个月PA、TPA比较，差异无统计学意义（P ＞ 0.05）。结论经Carlson后外侧入路锁定钢板手术可减少胫骨平台后外侧骨折患者术中出血量，骨折显露时间短，患者膝关节功能恢复效果显著，值得临床推广应用。

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	郭思远李环如吴胜祥

关键词 ：胫骨平台后外侧骨折, 关节功能, Carlson后外侧入路, 后正中入路, 锁定钢板, 优良率

Abstract：Objective To investigate the effect of locking plate surgery via the Carlson posterolateral approach on posterolateral tibial plateau fracture and its effect on joint function. Methods A total of 60 patients with posterolateral tibial plateau fracture admitted to the Anhui Wanbei Coal and Power Group General Hospital from January 2017 to January 2020 were selected and they were divided into observation group and control group according to random number table method, with 30 cases in each group. The observation group received locking plate surgery via the Carlson posterolateral approach, while the control group received locking plate surgery via the traditional posterior median approach. Intraoperative blood loss, fracture exposure time, surgery time, healing time, time to full weight bearing, incidence of complications and Rasmussen score of knee function six months after surgery were compared between the two groups. The changes of posterior slope angle (PA) and tibial plateau angle (TPA) of knee joint were compared between the two groups immediately after surgery and six months after surgery. Results The amount of intraoperative blood loss in the observation group was significantly less than that in the control group, and the fracture exposure time was significantly shorter than that in the control group, and the differences were statistically significant (all P < 0.05). There were no significant differences in surgery time, healing time and time to full weight bearing between the two groups (P ＞ 0.05). After surgery, there were no complications such as foreign body rejection and incision nonunion in the two groups. The excellent and good rate of Rasmussen score in observation group was significantly higher than that in control group, and the difference was statistically significant (P < 0.05). There were no significant differences in PA and TPA between the two groups immediately after surgery and six months after surgery (P ＞ 0.05). Conclusion Locking plate surgery via the Carlson posterolateral approach can reduce intraoperative blood loss in patients with posterolateral tibial plateau fracture, shorten fracture exposure time, and significantly restore the knee function of patients, which is worthy of clinical promotion and application.

Key words： Posterolateral tibial plateau fracture Joint function Carlson posterolateral approach Posterior median approach Locking plate Excellent and good rate

引用本文:

郭思远李环如吴胜祥. 经Carlson后外侧入路锁定钢板手术对胫骨平台后外侧骨折的疗效及对关节功能的影响[J]. 中国医药导报, 2021, 18(9): 108-111.
GUO Siyuan LI Huanru WU Shengxiang. Effect of locking plate surgery via the Carlson posterolateral approach on posterolateral tibial plateau fracture and its effect on joint function. 中国医药导报, 2021, 18(9): 108-111.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2021/V18/I9/108

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