CAJ | 학술논문

目的：比较后内侧倒L形入路联合前外侧入路内固定与前内侧联合前外侧入路内固定治疗累及双髁后侧复杂性胫骨平台骨折的临床效果。方法53例累及双髁后侧复杂性胫骨平台骨折患者，接受前内侧联合前外侧入路内固定29例（对照组），后内侧倒L形入路联合前外侧入路内固定24例（观察组），比较两组膝关节评分（ HSS）、骨折愈合时间及并发症发生情况。结果经12～26个月随访，观察组HSS评分总优良率高于对照组（ P ＜0．05），术后并发症发生率低于对照组（ P ＜0．05）；两组骨折愈合时间差异无统计学意义（ P ＞0．05）。结论对累及双髁后侧复杂性胫骨平台骨折，通过后内侧倒L形入路联合前外侧入路内固定治疗能提供良好的显露，损伤小，有利于骨折复位固定，且术后并发症少，是一种较为理想的手术方法。
목적：비교후내측도L형입로연합전외측입로내고정여전내측연합전외측입로내고정치료루급쌍과후측복잡성경골평태골절적림상효과。방법53례루급쌍과후측복잡성경골평태골절환자，접수전내측연합전외측입로내고정29례（대조조），후내측도L형입로연합전외측입로내고정24례（관찰조），비교량조슬관절평분（ HSS）、골절유합시간급병발증발생정황。결과경12～26개월수방，관찰조HSS평분총우량솔고우대조조（ P ＜0．05），술후병발증발생솔저우대조조（ P ＜0．05）；량조골절유합시간차이무통계학의의（ P ＞0．05）。결론대루급쌍과후측복잡성경골평태골절，통과후내측도L형입로연합전외측입로내고정치료능제공량호적현로，손상소，유리우골절복위고정，차술후병발증소，시일충교위이상적수술방법。
Objective To compare the clinical effect between posteromedial inverted L shape combined with anterior lateral approach and anteromedial combined with anterior lateral in treatment for complex tibial plateau fractures involving the rear double con -dyle.Methods Fifty-three cases of complex tibial plateau fractures involving the rear double condyle who had been operated on were retrospectively analyzed ,including 29 cases of anteromedial combined with anterior lateral ( control group ) and 24 cases of posteromedi-al inverted L shape combined with anterior lateral ( observation group ) .Knee function rehabilitation ,fracture union time and the rate of complications were evaluated .Results A 12-26 month-follow-up showed that the excellence rate of observation group was higher than that of control group ( P <0.05),but postoperative complication rate was lower than that of control group ( P <0.05).The difference of fracture union time in two groups was not statistically significant ( P >0.05).Conclusion Posteromedial inverted L shape com-bined with anterior lateral approach in treatment of complex tibial plateau fractures involving the rear double condyle can provide excell-lent exposure with less invasion and facilitate fracture reduction with less complications as an ideal surgical approach .