关键词: 双钢板固定术, 外侧入路, 倒L入路, 胫骨平台三柱骨折, 膝关节活动度

Abstract: Objective   To study the effect of double plate fixation through inverted L approach combined with lateral approach on the range of motion of knee joint in patients with three column fracture of tibial plateau. Methods   Retrospectively,88 patients with tibial plateau triple column fractures admitted in the orthopedic department of Beijing Tongren Hospital affiliated to Capital Medical University from November 2017 to December 2,2020 were selected as the study subjects and divided into control group and study group according to the treatment methods.The control group,44 patients had lateral approach double plate fixation,and 44 patients had lateral approach double plate fixation combined with inverted L approach.Compare the surgical efficacy and postoperative recovery between the two groups;compare the preoperative and postoperative knee function scores and quality of life scores between the two groups. Results   After operation,the operation time of the study group was (90.12±11.30) min,the intraoperative bleeding volume was (463.20±70.10) ml,and the hospital stay was (3.08±1.12) d,the time of knee joint exercise was (3.08±1.12) days,the time of complete fracture healing was (14.58±2.64) weeks and the time of complete weight-bearing was (16.27±3.65) weeks,which were shorter than those in the control group [(98.42±12.18) min,(502.41±77.10) ml,(20.36±3.12) d,(5.54±1.69) d,(16.06±3.27) weeks,(18.67±4.21) weeks] (P<0.05).In study group,the scores of the American Special Surgery Hospital (HSS)  were (87.06±10.06) points,the scores of the health survey summary (SF36)  was (82.69±10.30) points,the rate of excellent and good healing (93.18%),and the range of motion of the knee joint [knee extension (9.54±2.36),flexion (135.28±28.48)],which were higher than those of the control group [(80.26±9.20),(74.12±9.20),(77.27%),(8.06±2.06) and (121.64±22.61)] (P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups (P>0.05).  Conclusion   The treatment of patients with three column fracture of tibial plateau with lateral approach double plate fixation combined with inverted L approach can improve the range of motion of knee joint,promote fracture healing and improve the quality of life.

Key words: double plate fixation, lateral approach, inverted L approach, three column fracture of tibial plateau, knee range of motion