改良Frosch入路与传统前外侧入路治疗后外侧胫骨平台骨折的效果分析

目的 比较改良Frosch入路与传统前外侧入路在治疗后外侧胫骨平台骨折方面的疗效，评价改良Frosch入路在治疗后外侧胫骨平台骨折中的安全性、实用性及有效性。方法 通过分析2020年1月至2022年6月就诊于安徽医科大学附属宿州医院因后外侧胫骨平台骨折行手术治疗的56例病例资料，其中采用改良Frosch入路的病人29例，作为观察组。传统前外侧入路的病人27例，作为对照组。手术均由同一位医生完成。对手术时间、术中出血量、骨折愈合时间、术前疼痛强度、末次随访时疼痛强度、术后3、6个月膝关节功能，术后3、6个月膝关节屈伸活动度、术后相关并发症发生进行分析。结果 观察组手术时间（117.00±1.25）min明显较对照组（132.52±1.12）min更快，差异有统计学意义（P<0.05）；观察组术中出血量（108.97±2.41）mL少于对照组术中出血量（136.85±1.63）mL，差异有统计学意义（P<0.05）；观察组骨折愈合时间（4.53±0.05）月稍快于对照组（4.64±0.05）月，差异无统计学意义（P>0.05）；术前及末次随访时疼痛强度观察组与对照组相比，...

The effect of modified Frosch approach and traditional anterolateral approach on posterolateral tibial plateau fractures

Objective To evaluate the safety, practicability, and effectiveness of a modified Frosch approach in the treatment of pos.terolateral tibial plateau fractures by comparing it with the conventional anterolateral approach.Methods The data of 56 cases, whounderwent surgical treatment for posterolateral tibial plateau fractures at Suzhou Hospital Affiliated to Anhui Medical University be.tween January 2020 and June 2022, were analyzed, 29 patients who underwent a modified Frosch approach were included as an obser.vation group, and 27 patients treated with a conventional anterolateral approach served as a control group. The procedures were all per.formed by the same surgeon.Analysis was performed on the duration of surgery, intraoperative blood loss, fracture healing time, preoper.ative pain intensity, pain intensity at last follow-up, knee function at postoperative 3 and 6 months, knee flexion and extension mobilityat postoperative 3 and 6 months, and occurrence of postoperative related complications.Results In the observation group, the surgery durationwas significantly faster than that in the control group (117.00±1.25) min vs.(132.52±1.12) min], and the difference was statisti. cally significant (P<0.05). The intraoperative blood loss of the observation group was less than that of the control group (108.97±2.41) mL vs.(136.85±1.63) mL] withstatistically significant difference(P<0.05).The fracture healing time in the observation group was slightly faster than that in the control group (4.53±0.05) months vs.(4.64±0.05) months], with no significant difference (P>0.05). There was nosignificant difference in pain intensity between the observation group and the control group before surgery and at the last follow-up (P> 0.05). The knee function scores were (56.28±0.63),(85.83±1.20) at 3 and 6 months postoperatively in the observation group and (55.15±0.17), (83.44±0.22) at 3 and 6 months postoperatively in the control group; although the knee function scores of the observation groupwere higher than those of the control group, they were not significantly different (P>0.05). The knee flexion and extension activities were (112.97±0.94)°, (119.45±0.97) °at 3 and 6 months postoperatively in the observation group and (111.26±0.69)°,(117.78±0.87)° at3 and 6 months postoperatively in the control group; although the knee flexion and extension activities of the observation group weregreater than those of the control group, they were not significantly different (P>0.05). There was no significant difference between theobservation group and the control group in the incidence of related complications (P>0.05). Conclusion The modified Frosch ap.proach is safe and reliable in the treatment of posterolateral fractures of the tibial plateau.And in comparison with the anterolateral inci.sion, in addition to ensuring the safety of the procedure, it shortens the surgery duration and reduces intraoperative blood loss with satis.factoryreduction, which has some advantages and deserves further clinical promotion.