叶　方　黄淑明　兰树华

浙江省丽水市中心医院创伤骨科，浙江丽水323000

腓骨头上入路治疗胫骨平台后外侧骨折的临床研究

叶方黄淑明兰树华▲

浙江省丽水市中心医院创伤骨科，浙江丽水323000

目的探讨腓骨头上入路治疗胫骨平台后外侧骨折的临床效果。方法选取我院2010年1月～2014年12月43例胫骨平台后外侧骨折患者进行研究，根据治疗方法不同将43例患者分为试验组（23例患者进行腓骨头上入路治疗）和对照组（20例患者采用传统手术方法），治疗后随访1年时间，观察患者总有效率、骨折愈合情况、不良反应及预后的膝关节功能HSS评分。结果试验组的总有效率（95.7%）明显高于对照组（75.0%），差异有统计学意义（P＜0.05）；试验组患者的骨折愈合率（95.7%）明显高于对照组（70.0%），差异有统计学意义（P＜0.05）；试验组的不良反应发生率（12.9%）明显低于对照组（55.0%），差异有统计学意义（P＜0.05）；试验组的膝关节功能HSS评分（92.3±10.2）分明显优于对照组（65.3±10.8）分，差异有统计学意义（P＜0.05）。结论采用腓骨头上入路治疗胫骨平台后外侧骨折可以提高患者的骨折愈合，安全且功能恢复好。

胫骨平台后外侧骨折；骨折固定术；骨折愈合；不良反应

［Abstract］Objective To explore the clinical effect of the fibula head approach in treatment of lateral tibial plateau fractures.Methods From January 2010 to December 2014，43 cases of patients with lateral tibial plateau fractures were studied.According to the different treatment methods，43 patients were divided into experimental group（23 cases of patients were treated with the fibular head approach）and control group（20 patients were treated with traditional surgical method），patients were followed up for 1 year，the total effective rate，fracture healing，adverse reaction and prognosis of the HSS scores were observed.Results The total efficiency（95.7%）of the experimental group was significantly higher than that of the control group（75.0%），with significant difference（P＜0.05）；fracture healing rate（95.7%）of the experimental group was significantly higher than that of the control group（70.0%），with significant difference（P＜0.05）；the adverse reaction incidence rate（12.9%）of the experimental group was significantly lower than the control group（55.0%），with significant difference（P＜0.05）.The HSS knee score（92.3±10.2）points of experimental group was significantly better than the control group（65.3±10.8），with significant difference（P＜0.05）.Conclusion The treatment of fractures of the tibial plateau can be improved by the approach of the upper tibia in the treatment of tibial plateau fractures.

［Key words］Lateral tibial plateau fractures；Fracture fixation；Fracture healing；Adverse reaction

胫骨平台后侧劈裂骨折是一种特殊类型的平台骨折，主要分为外后侧髁骨折和内后侧髁骨折，而且对于不同骨折形式的诊断和治疗方法存在一定的差异［1，2］。目前对内后侧髁骨折的诊断与治疗方法已经比较成熟，而对外后侧髁骨折的诊断与治疗没有明确的方法，采用传统的手术方法进行固定比较困难……