| 后路小切口和微小切口治疗复杂胫骨平台伴后髁骨折的病例对照研究 |
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投稿时间：2010-03-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 李艳超 |
LI Yan-chao |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 扶世杰 |
FU Shi-jie |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
fu_fsj@sina.com |
| 肖复燊 |
XIAO Fu-shen |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 伍光辉 |
WU Guang-hui |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 黄家骏 |
HUANG Jia-jun |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 熊福生 |
XIONG Fu-sheng |
泸州医学院附属中医医院,四川 泸州 646000 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 彭良宁 |
PENG Liang-yu |
纳溪县中医院 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 廖小彬 |
LIAO Xiao-bin |
赤水市中医院 |
The TCM Hospital Affiliated to Medicine College of Luzhou,Luzhou 646000,Sichuan,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第6期，第417-420页 |
| DOI：10.3969/j.issn.1003-0034.2010.06.006 |
| 基金项目: |
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中文摘要:
目的：探讨复杂胫骨平台伴后髁骨折采用前正中切口联合后路小切口，前正中切口联合后路微小切口两种术式治疗后的疗效。
方法：回顾性研究2000年至2008年79例共81肢复杂胫骨平台伴后髁骨折，39肢行前正中切口联合后路小切口，男21肢，女18肢；按Schatzker分类:Ⅳ型13肢，Ⅴ型15肢，Ⅵ型11肢。42肢行前正中切口联合后路微小切口，男25肢，女17肢(男24例，女16例，其中男1例和女1例为双侧复杂胫骨平台伴后髁骨折)；按Schatzker分类:Ⅳ型18肢，Ⅴ型16肢，Ⅵ型8肢。术后采用Rasmussen膝关节功能和放射学评分法评估疗效，并观察皮肤坏死、切口感染等并发症出现情况。
结果：所有病例均获随访，按Rasmussen膝关节功能评估:后路小切口组优16肢，良13肢，可7肢，差3肢；后路微小切口组优19肢，良11肢，可8肢，差4肢，两组比较P=0.924。按Rasmussen膝关节放射学评级标准评估:后路小切口组优16肢，良13肢，可7肢，差3肢；后路微小切口组优19肢，良11肢，可8肢，差4肢， 两组比较P=0.722。出现皮肤坏死、切口感染等并发症:小切口组10肢，微小切口组4肢， 两组比较P=0.047。
结论：采用后路小切口与后路微小切口治疗胫骨平台伴后髁骨折在膝关节功能康复方面无明显差异，后路微小切口较后路小切口有更小的皮肤坏死和切口感染率。 |
| 【关键词】胫骨骨折 外科手术 膝关节 手术后并发症 病例对照研究 |
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| Case-control studies on complex tibial plateau and posterior condylar fractures treated through combined anterior-posterior(small incision or micro-incision) approach |
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ABSTRACT
Objective: To study the therapeutic effects of combined anterior-posterior(small incision or micro-incision) approach for complex tibial plateau and posterior condylar fractures.
Methods: From 2000 to 2008,79 patients(81 limbs) with complex tibial plateau and posterior condylar fractures were reviewed. There were 45 males and 34 females,ranging in age from 19 to 66 years,with an average of 40.6 years. Thirty-nine limbs were treated using small incision through combined anterior-posterior approach,in which 13 limbs were Schatzker typeⅣ,15 limbs were typeⅤ,and 11 limbs were typeⅥ. Other 42 limbs were treated using micro-incision through combined anterior-posterior approach,in which 18 limbs were Schatzker typeⅣ,16 limbs were typeⅤ,and 8 limbs were typeⅥ. The Rasmussen scores for knee joint and radio scores were used to evaluate therapeutic effects after the treatment. The complications such as cutaneous necrosis and incision infection were observed.
Results: All the patients were followed up. According to Rasmussen criterion,in small incision group, 16 limbs got an excellent result,13 good,7 fair and 3 bad；in micro-incision group,above data were 19,11,8 and 4 respectively. Comparison between the two groups,P=0.924. Comparison of complications such as cutaneous necrosis and incision infection: in small incision group,10 limbs had the complications,and in micro-incision group were 4 limbs；the occurrence rate of small incision group were higher than that of micro-incision group(P=0.047).
Conclusion: There are no significant differences between the two groups in the knee joint function rehabilitation；however,there is smaller rate for cutaneous necrosis and incision infection in micro-incision group. |
| KEY WORDS Tibial fractures Surgical procedures,operative Knee joint Postoperative complications Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李艳超,扶世杰,肖复燊,伍光辉,黄家骏,熊福生,彭良宁,廖小彬.后路小切口和微小切口治疗复杂胫骨平台伴后髁骨折的病例对照研究[J].中国骨伤,2010,23(6):417~420 |
| 英文格式: | LI Yan-chao,FU Shi-jie,XIAO Fu-shen,WU Guang-hui,HUANG Jia-jun,XIONG Fu-sheng,PENG Liang-yu,LIAO Xiao-bin.Case-control studies on complex tibial plateau and posterior condylar fractures treated through combined anterior-posterior(small incision or micro-incision) approach[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(6):417~420 |
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