背景:胫骨平台骨折是临床上常见的骨折。
目的:本研究确定了胫骨平台骨折患者的最佳手术时机和手术入路。
方法:我院(中江县人民医院)2013~2015年收治复杂胫骨平台骨折患者52例。这些患者被招募为这项研究的参与者;所有患者被随机分为两组,每组26名患者。第1组患者接受单切口,通过前外侧入路进行单板膝关节手术,第2组患者行膝关节前正中切口行双板手术.对这些方法的效果进行了比较和分析。
结果:进行手术的最佳时间是受伤后6-8天。前正中切口,双板法优于前外侧法,单切口,单板法。对于前一种方法,中青年患者的愈合情况优于老年患者,男性患者的愈合情况略好于女性患者。然而,术后5个月患者的愈合程度>80%。手术管理的目的已完全达到。
结论:复杂胫骨平台骨折患者的最佳手术时机是损伤后6-8天。手术方法需要根据患者的实际情况来确定。然而,前正中切口的治疗效果,双板法比较好,术后5个月恢复率可能接近80%。
BACKGROUND: Tibial plateau fracture is a common fracture encountered in the clinic.
OBJECTIVE: This study determined the optimal timing and surgical approach for patients with tibial plateau fracture.
METHODS: Fifty-two patients with complex tibial plateau fractures were treated in our hospital (the People\'s Hospital of Zhongjiang County) between 2013 and 2015. These patients were recruited as participants in this study; all patients were randomly allocated into two groups of 26 patients each. Patients in Group 1 underwent single-incision, single-plate knee surgeries via an antero-lateral approach, and patients in Group 2 underwent anterior median incisions of the knee for double-plate surgeries. The effects of the approaches were compared and analyzed.
RESULTS: The best time to perform surgery was 6-8 days post-injury. The anterior median incision, double-plate method approach was better than the antero-lateral, single-incision, single-plate method. For the former method, the healing among middle-aged and young patients was better than that of elderly patients, and that healing of men was slightly better than that of female patients. However, the degree of healing among patients was > 80% at 5 months postoperatively. The purpose of surgical management has been fully achieved.
CONCLUSIONS: The optimal timing of surgery for patients with complex tibial plateau fractures is 6-8 days post-injury. The surgical approach needs to be determined based on the actual condition of the patient. However, the treatment effect of an anterior median incision, double-plate method is better, and the recovery rate may approach 80% at 5 months postoperatively.