髌骨旁中线关节切开术:胫骨外侧平台骨折的安全替代方法

IF 1.6 3区 医学 Q3 ORTHOPEDICS
Nathan Heineman, Alexander Turner, Mingyuan Cheng, Ishvinder Grewal, Drew Sanders, Ashoke Sathy
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引用次数: 0

摘要

目的:一项尸体研究显示,与前外侧入路(AL)相比,中线外侧髌旁(LP)入路能提供更好的关节暴露。本研究的目的是报告 LP 方法的效果和并发症:方法:设计:方法:设计:回顾性比较队列研究和前瞻性队列研究:患者选择标准:随访至少 3 个月的成年患者:2010-2019年间,通过LP关节切开术或AL半月板下关节切开术对急性孤立性胫骨外侧平台骨折(OTA/AO 41-B1、41-B2、41-B3)进行切开复位内固定术(ORIF)的成年患者,随访至少3个月:回顾性队列评估术后并发症,包括感染、伤口愈合延迟和再手术率。前瞻性队列采用短期肌肉骨骼功能评估(SMFA)、膝关节活动范围(ROM)和并发症进行评估:LP队列的平均年龄为41.5岁(19-79岁),18/32(56.3%)为男性。AL组患者的平均年龄为42.8岁(18-71岁),29/49(59.2%)为男性。前瞻性研究中患者的平均年龄为 31.4 岁(19-59 岁),9/14(64.3%)为男性。回顾性研究和前瞻性研究的平均随访时间分别为 9.3 个月和 20.3 个月。并发症和再次手术率没有明显差异(P>0.39)。前瞻性队列的平均ROM为130度。平均SMFA功能障碍指数(DI)为9.0,平均困扰指数(BI)为11.1:髌旁外侧入路的临床和功能结果与历史上采用前外侧入路的结果相当。这是一种安全的替代方法,在治疗粉碎性胫骨外侧平台骨折时可能最有益处:证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Midline Lateral Parapatellar Arthrotomy: A Safe Alternative Approach for Lateral Tibial Plateau Fractures.

Objectives: The midline lateral parapatellar (LP) approach has been shown in a cadaveric study to provide superior articular exposure compared with the anterolateral approach (AL). The purpose of this study was to report on outcomes and complications with the LP approach.

Methods:

Design: Retrospective comparative cohort study and prospective cohort.

Setting: Academic Level-I trauma center.

Patient selection criteria: Adult patients with minimum 3 months follow-up who underwent open reduction internal fixation of an acute, isolated lateral tibial plateau fracture (OTA/AO 41-B1, 41-B2, 41-B3) through an LP arthrotomy or AL submeniscal arthrotomy between 2010 and 2019.

Outcome measures and comparisons: Retrospective cohort evaluated using postoperative complications including infection, delayed wound healing, and reoperation rate. Prospective cohort evaluated using Short Musculoskeletal Function Assessment, knee range of motion, and complications.

Results: A total of 81 patients were studied. The mean age for the LP cohort was 41.5 years (19-79) and 18 of 32 (56.3%) patients were men. The mean age for the AL cohort was 42.8 years (18-71) and 29 of 49 (59.2%) patients were men. The mean age for patients in the prospective study was 31.4 years (19-59) and 9 of 14 (64.3%) patients were men. Mean follow-up was 9.3 months and 20.3 months for the retrospective and prospective cohorts, respectively. There was no significant difference in complication or reoperation rate ( P > 0.39). For the prospective cohort of 14 patients, mean range of motion was 130 degrees. Mean Short Musculoskeletal Function Assessment dysfunction index was 9.0 and mean bother index was 11.1.

Conclusions: The LP approach resulted in comparable clinical and functional outcomes with those reported with the anterolateral approach. It is a safe alternative and may be of most benefit when treating comminuted lateral tibial plateau fractures.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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来源期刊
Journal of Orthopaedic Trauma
Journal of Orthopaedic Trauma 医学-运动科学
CiteScore
3.90
自引率
8.70%
发文量
396
审稿时长
3-8 weeks
期刊介绍: Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.
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