目的：探讨评价两种手术切口入路治疗复杂胫骨平台骨折的方法及疗效。方法：总结26例复杂胫骨平台骨折患者膝正中切口与内外联合切口的治疗差异，选取2005年1月～2011年11月26例复杂胫骨平台骨折手术患者，按Schatzker分型，其中V型17例，VI型9例，其中男18例，女8例；平均年龄47岁（36～65岁）；左侧7例，右侧19例。致伤原因：交通伤18例，坠落伤3例，跌伤5例；均为闭合性骨折。经膝正中切口17例，经内外联合切口9例，分析2种手术径路治疗结果、关节功能及切口的愈合。结果：两种手术径路手术相比，术后并发症发生率，术后下肢功能恢复及术后平均恢复时间差异有统计学意义。结论：经内外联合切口，减少手术伤口并发症，切口愈合情况比较好，双钢板固定可靠，可以早期进行功能锻炼，让患者获得满意的治疗效果。%Objective:Explore and efficacy evaluation of two surgical incision in the treatment of complex tibial plateau fractures. Methods:Summary of 26 cases of complex tibial plateau fractures in patients with knee midline incision and the incision within and outside the treatment difference. Select the the 2005 January to 2011 November, 26 cases of complex tibial plateau fractures in patients, Schatzker points where V 17 cases, Ⅵin 9 cases, including 18 males and 8 females; mean age 47 years (36~65years);seven cases of the left side, right side in 19 cases. The causes of injury:traffic injuries in 18 cases, three cases fall injury, falls five cases;were closed fractures. Midline incision and 17 cases by the knee, inside and outside the joint incision of 9 cases, the analysis of two kinds of operative approach in the treatment of results, joint function and incision healing. Result:Two surgical approaches compared to surgery, the incidence of postoperative complications, postoperative lower extremity functional recovery and postoperative average of recovery time difference was statistically significant. Conclusion:Inside and outside the incision, to reduce surgical wound complications, wound healing, with two plates is fixed and reliable, early functional exercises, to enable patients to obtain a satisfactory therapeutic effect.
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