摘要
目的探讨倒L入路经腘窝腓肠肌内外侧头双间隙治疗累及后柱的胫骨平台骨折患者的效果及功能恢复情况。方法选取2020年3月至2023年3月在南通大学第二附属医院实施手术治疗的109例[男74例,女35例,年龄(42.4±7.9)岁]累及后柱的胫骨平台骨折患者进行回顾性研究,根据手术入路方式进行分组,其中55例患者采用倒L入路经腘窝腓肠肌内外侧头双间隙治疗(倒L组),54例患者采用传统的标准前外侧入路方式实施手术(传统组),采用独立样本t检验对比两组的手术相关指标、膝关节功能指标,采用χ^(2)检验对比两组的并发症。结果倒L组的平均手术时间、平均住院时间、承重时间、骨折愈合时间均低于传统组,差异均有统计学意义[(142.4±10.2)min比(151.2±13.5)min、(15.6±2.4)d比(17.5±2.6)d、(5.9±0.8)周比(6.4±0.9)周、(15.3±1.6)周比(16.8±1.9)周,t=3.407、-3.965、-3.067、-4.461,P<0.05]。结论倒L入路经腘窝腓肠肌内外侧头双间隙治疗累及后柱的胫骨平台骨折较传统的标准前外侧入路更有利于患者膝关节功能恢复、促进早期康复。
Objective To explore the effectiveness and functional recovery via the inverted L approach in the treatment of tibial plateau fractures involving the posterior column through the internal and external head gaps of the popliteal and gastrocnemius muscles.Methods A retrospective study was conducted on 109 patients[74 males,35 females,average age(42.4±7.9)years]with tibial plateau fractures involving the posterior column who underwent surgical treatment at the Affiliated Hospital of Nantong University from March 2020 to March 2023.They were grouped according to the surgical approach.Among them,55 patients were treated with the inverted L approach through the medial and lateral head double spaces of the popliteal gastrocnemius muscle(inverted L group),and 54 patients underwent surgery using the traditional standard anterolateral approach(traditional group).The independent sample t-test was used to compare the surgery-related indicators and knee joint function indicators of the two groups,and theχ^(2) test was used to compare the complications of the two groups.Results The inverted L group showed significantly shorter mean operative time,hospital stay,time to weight-bearing,and fracture healing time than the conventional group[(142.4±10.2)min vs.(151.2±13.5)min,(15.6±2.4)d vs.(17.5±2.6)d,(5.9±0.8)weeks vs.(6.4±0.9)weeks,(15.3±1.6)weeks vs.(16.8±1.9)weeks,t=3.407,-3.965,-3.067,-4.461,P<0.05].Conclusion The treatment of tibial plateau fractures involving the posterior column through the internal and external head gaps of the popliteal and gastrocnemius muscles via the inverted L-approach is more conducive to the recovery of knee joint function and promotes early recovery than the traditional standard anterolateral approach.
作者
范建波
张亚峰
王友华
陶叶龙
朱新辉
刘巍
崔胜宇
Fan Jianbo;Zhang Yafeng;Wang Youhua;Tao Yelong;Zhu Xinhui;Liu Wei;Cui Shengyu(Department of Orthopedics,Affiliated Hospital of Nantong University,Nantong 226000,China;Department of Orthopedics,Affiliated Hospital 2 of Nantong University,Nantong 226000,China)
出处
《中华实验外科杂志》
2025年第7期1381-1384,共4页
Chinese Journal of Experimental Surgery
基金
国家自然科学基金(81501866)
南通市自然科学基金(JC2023039)
南通市青年医学专家基金。
关键词
胫骨平台骨折
膝关节功能
关节活动度
Tibial plateau fracture
Knee joint function
Joint range of motion
