ObjectiveTo investigate the clinical effects and application value of three plate-fixation with anterolateral single incision in the treatment of three-column fractures of tibial plateau.
MethodsForty-six patients with three-column fractures of tibial plateau from January 2010 to February 2017 were divided into the observation group and control group according to the random number method(23 cases in each group).The observation group was treated with three-plate fixation with anterolateral single incision, and the control group was treated with anterolateral incision combined with retromedial inverted L-shape double incision and three-plate fixation.The postoperative treatment in two groups were the same, the clinical and imaging examinations were conducted regularly, and the knee joint function was evaluated using Rasmussen radiological score and American hospital for special surgery(HSS) score.
ResultsAll cases were followed up for 18-24 months.The operation time, intraoperative blood loss and postoperative drainage volume in observation group were significantly less than those in control group(P < 0.01), and there was no statistical difference in the healing time of fracture between two groups(P>0.05).There was no statistical significance in values of varus angle and rake angle between two groups before and after surgery(P>0.05), while the values of varus angle and rake angle in two groups after operation were significantly less than those before operation(P < 0.01).There was no statistical significance in Rasmussen radiology score and HSS knee function score between two groups after 6 and 18 months of operation, and the difference of which in two groups between before and after treatment was not statistically significant(P>0.05).The different of the infection rate in two group was not statistically significant(P>0.05).
ConclusionsCompared with the anterolateral incision combined with retromedial inverted L-shape three-plate fixation, the three-plate fixation with anterolateral single incision in treating the tibial plateau three-column fractures can restore the joint surface smooth and mechanical stability, and there is no significant difference in the function of knee joint between two groups.The three-plate fixation with anterolateral single incision in treating the tibial plateau three-column fractures is better than that of the anterolateral incision combined with retromedial inverted L-shape three-plate fixation, which has the advantages of simple operation, less trauma, shorter operation time, less bleeding and ease to change medicine, and can obviously reduce the risk of infection, so it is worthful of popularization in clinic.
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