后正中小切口斜“T”形板固定胫骨后外侧平台骨折△（开放获取）

(Open Access) Oblique T-shaped buttress plate for posterolateral tibial plateau fractures through a posterior midline small incision

摘要:

[目的] 探讨后正中小切口斜“T”形板固定胫骨后外侧平台骨折的疗效。[方法] 回顾性分析2018 年6 月—2022年6 月本科治疗的21 例存在后外侧塌陷的胫骨平台骨折患者的临床资料。所有病例采用斜“T”板经后正中小切口固定后外侧骨块。评价临床及影像结果。[结果] 21 例患者均顺利完成手术，术中未出现血管、神经损伤等并发症。手术时间平均（119.1±11.5） min，切口长度平均（6.1±1.1） cm。所有患者获得随访，随访时间平均（16.3±1.4） 个月。随术后1、3 个月和末次随访的时间推移，患者VAS 评分[(1.2±1.3), (0.5±0.8), (0.0±0.0), P＜0.001]、HSS 评分[(48.6±11.5), (69.6±12.6), (91.3±5.5), P＜0.001]、膝ROM [(91.1±20.2)°, (114.4±11.5)°, (123.4±8.7)°, P＜0.001] 均显著改善。影像方面，与术后1 个月相比，术后3 个月及末次随访时，胫骨近端内侧角（medial proximal tibial angle, MPTA）、胫骨平台后倾角（posterior tibial slope, PTS） 和Rasmussen影像评分均无显著变化（P＞0.05）。[结论] 采用后正中小切口斜“T”形板固定胫骨后外侧平台骨折，疗效优良。

Abstract:

[Objective] To investigate the clinical outcomes of oblique T-shaped buttress plate for posterolateral tibial plateau frac-tures through a posterior midline small incision. [Methods] A retrospective research was done on 21 patients who received open reductionand internal fixation for tibial plateau fractures complicated with posterolateral plateau collapse from June 2018 to June 2022. All the pa-tients had the posterolateral bone fragments fixed with an oblique T-shaped buttress plate through a posterior midline small incision. Clini-cal and imaging documents were evaluated. [Results] All the 21 patients successfully completed the operation, without vascular, nerve inju-ry and other complications occurred during the operation, while with operation time of (119.1±11.5) min, and incision length was (6.1±1.1)cm. All patients were followed up for an average of (16.3±1.4) months. As time went from 1 month, 3 months postoperatively to the last fol-low-up, the VAS score [(1.2±1.3), (0.5±0.8), (0.0±0.0), P＜0.001], HSS score [(48.6±11.5), (69.6±12.6), (91.3±5.5), P＜0.001], knee ROM[(91.1±20.2)°, (114.4±11.5)°, (123.4±8.7)°, P＜0.001] significantly improved. In term of imaging, compared with those 1 month after sur-gery, the medial proximal tibial angle (MPTA), posterior tibial slope (PTS) and Rasmussen image scores remained unchanged 3 months aftersurgery and at the last follow-up (P＞0.05). [Conclusion] This oblique T-shaped buttress plate for posterolateral tibial plateau fracturesthrough a posterior midline small incision has good clinical consequences in this study.