目的:探讨经腓骨小头上入路治疗胫骨平台后外侧髁塌陷骨折的手术方法及术后临床疗效.方法:自 2013年10月至2016年12月,采用经腓骨小头上入路治疗11例胫骨平台后外侧髁塌陷患者,其中男9例,女2例;年龄25～60岁,平均39.7岁;受伤至手术时间4～10d,平均6.5 d;均为闭合性损伤.术后观察切口愈合情况及骨折愈合情况,并于术后即刻和末次随访时采用X线片测量胫骨平台内翻角、后倾角,采用美国特种外科医院HSS膝关节评分进行临床疗效评价.结果:术后11例患者获得随访,时间11～13个月.手术时间55?90 min,术后切口均I期愈合,骨折愈合时间7?12周.术后即刻胫骨平台内翻角、后倾角与末次随访时比较差异无统计学意义(P<0.05);HSS膝关节评分80～93,其中优6例,良5例.结论:经腓骨小头上入路治疗胫骨平台后外侧髁塌陷骨折,手术操作简便,创伤小,有利于患者膝关节功能恢复,临床效果满意.%Objective :To evaluate surgical method and clinical efficacy for the treatment of depression fractures of posterolateral tibial plateau through superior fibular head approach. Methods :Eleven patients with depression fractures of posterolateral tibial plateau through superior fibular head approach were treated from October 2013 to December 2016, including 9 males and 2 females with an average age of 39.7 years old ranged from 25 to 60 years old. The time from injure to operation ranged from 4 to 10 days with an average of 6.5 days. All fractures were closed fracture. Incision healing, tibial plateau varus angles and posterior slope angle were measured through X-rays immediately after operation and latest follow-up. At final follow-up,HSS score of knee joint were used to evaluate clinical effects. Results :Eleven patients were followed up ranged from 11 to 13 months ranged from 55 to 90 min. All incisions were healed at stage I. Fracture healing time ranged from 7 to 12 weeks. There were no significant differences of tibial plateau varus angles and posterior slope angles comparing between immediately opertaion and latest follow-up (P<0.05). At the final follow up,HSS scores ranged from 80 to 93 points,6 cases were excellent and 5 moderate. Conclusion :Depression fractures of posterolateral tibial plateau through superior fibular head approach has advantages of simple operation,less invasive,benefit for recovery of knee joint function,and could receive clinical effects.
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