MODIFIED POSTEROLATERAL COUNTER-CURVED INCISION WITH DOUBLE INTERMUSCULAR APPROACH IN TREATING POSTEROLATERAL TIBIAL PLATEAU FRACTURES

OBJECTIVE: To evaluate the effectiveness of the modified posterolateral counter-curved incision with double intermuscular approach for the treatment of posterolateral tibial plateau fractures. 方法: 2012年9月－2014年10月，收治32例后外侧胫骨平台塌陷骨折患者。男22例，女10例；年龄19~55岁，平均40.5岁。致伤原因：交通事故伤17例，高处坠落伤9例，摔伤6例。均为新鲜闭合性骨折；受伤至入院时间为3 h~5 d，平均2 d。根据Schatzker胫骨平台骨折分型标准：Ⅱ型20例，Ⅲ型12例。采用经后外侧反弧形切口双肌间隙入路，在腘肌和比目鱼肌间隙以及胫前肌两个间隙分别显露胫骨后外侧髁及前外侧髁，直视下复位骨折并钢板内固定。. RESULTS: The incisions healed at stage I, with no major neurovascular injury. According to radiological assessment of the DeCoster score, the results were excellent in 21 cases, and fair in 11 cases. All of the 32 patients were followed up 18 to 30 months (mean, 20.5 months). The X-ray films showed that all patients obtained good fracture union, and the mean time of fracture union was 12.3 weeks (range, 10-16 weeks). No fixation failure or no obvious loss of articular surface reduction was observed during follow-up. The range of motion of the affected knees was 2-135° (mean, 120°). The mean American Hospital for Special Surgery (HSS) score was 90.05 (range, 83-96) at 18 months after operation. 结论: 经后外侧反弧形切口双肌间隙入路可以充分显露后外侧塌陷胫骨平台，并兼顾显露胫骨前外侧平台骨折，直视下骨折复位良好，经支撑钢板固定外侧胫骨平台，可获得满意生物力学稳定。.