| 王逸三,王培召,曹国瑞,等.保留髂胫束与胫骨前肌腱入路治疗外侧胫骨平台骨折的初步疗效观察.骨科,2025,16(5): 406-412. |
| 保留髂胫束与胫骨前肌腱入路治疗外侧胫骨平台骨折的初步疗效观察 |
| Efficacy of iliotibial band and tibialis anterior tendon preservation approach in the treatment of lateral tibial plateau fractures |
| 投稿时间：2025-04-27 |
| DOI：10.3969/j.issn.1674-8573.2025.05.004 |
| 中文关键词: 胫骨平台骨折 改良入路 胫骨前肌腱 髂胫束 |
| 英文关键词: Tibial plateau fractures Modified approach Anterior tibial tendon Iliotibial band |
| 基金项目:河南省科技攻关项目（242102310025）；河南省留学人员科研择优资助专项（2024-11）；河南省中医药科学研究专项课题（2024ZY3067）；河南省博士后科研资助项目（365154） |
|
| 摘要点击次数: 122 |
| 全文下载次数: 109 |
| 中文摘要: |
| 目的 探讨保留髂胫束与胫骨前肌腱入路治疗外侧胫骨平台骨折的疗效。方法 回顾性分析2022年4月至2024年4月在河南省洛阳正骨医院（河南省骨科医院）采用保留髂胫束与胫骨前肌腱入路治疗的20例外侧胫骨平台骨折病人的临床资料，其中男8例，女12例；年龄为（50.9±14.2）岁（28~74岁）。记录病人手术时间、术中出血量、术后切口愈合时间、下地部分负重时间、弃拐完全负重时间，术前、术后即刻、术后3个月及末次随访时的胫骨平台后倾角（posterior tibial slope，PTS）、胫骨平台角（tibial plateau angle，TPA）和末次随访时的胫骨平台骨折Rasmussen放射学评分。采用美国特种外科医院（Hospital for Special Surgery，HSS）膝关节评分、疼痛视觉模拟量表（visual analogue scale，VAS）评分和末次随访膝关节活动度（range of motion，ROM）评价临床效果。结果 病人手术时间为（107.3±19.8） min（70~150 min），术中出血量为（24.0±15.0） mL（10~60 mL），切口愈合时间为（15.4±2.1）天，下地部分负重时间为（6.9±1.3）周，弃拐完全负重时间为（15.3±1.6）周。病人均获得随访，随访时间为（16.2±2.8）个月。随访期间未发生骨折再移位、关节不稳定、内固定松动等并发症。术后病人VAS评分、HSS评分、PTS、TPA均显著改善，末次随访膝ROM为130.3°±2.3°，胫骨平台骨折Rasmussen放射学评分均为优。结论 采用保留髂胫束与胫骨前肌腱入路治疗胫骨平台骨折可充分暴露术野，减轻髂胫束及切口周围软组织损伤，病人恢复结果良好，疗效满意。 |
| 英文摘要: |
| Objective To investigate the efficacy of iliotibial band and tibialis anterior tendon preservation approach in the treatment of lateral tibial plateau fractures. Methods A retrospective analysis was conducted on the clinical data of 20 patients with lateral tibial plateau fractures treated by the iliotibial band preserving and anterior tibial tendon preservation approach from April 2022 to April 2024 in the Luoyang Orthopedics Hospital (Henan Orthopedics Hospital), including 8 males and 12 females, aged (50.9±14.2) years old (28-74 years old). The surgical time, intraoperative blood loss, postoperative incision healing time, lower ground weight-bearing time, complete weight-bearing time of crutches, posterior tibial slope (PTS), tibial plateau angle (TPA) before surgery, immediately after surgery, 3 months after surgery, and at the last follow-up, as well as the Rasmussen radiological score of tibial plateau fracture at the last follow-up was recorded. The clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee joint score, visual analogue scale (VAS) pain score, and range of motion (ROM) at the last follow-up. Results The operation time was (107.3±19.8) min (range, 70-150 min), the intraoperative blood loss was (24.0±15.0) mL (range, 10-60 mL), the wound healing time was (15.4±2.1) days, and the weight-bearing time was (6.9±1.3) weeks. The time of full weight-bearing was (15.3±1.6) weeks. All patients were followed up for (16.2±2.8) months. During the follow-up, there was no complication such as fracture re-displacement, joint instability, and internal fixation loosening. The VAS score, HSS score, PTS and TPA were significantly improved after operation. The knee ROM was 130.3°±2.3° at the last follow-up, and the Rasmussen radiological score of tibial plateau fracture was excellent. Conclusion The iliotibial band and tibialis anterior tendon preservation approach in the treatment of tibial plateau fractures can fully expose the surgical field, reduce the iliotibial band and soft tissue injury around the incision, and the patients have good recovery results and satisfactory results. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
