Clinical Observation of Internal and External Head Approach through Popliteal Gastrocnemius in the Treatment of Tibial Plateau Fractures Involving Posterior Column
LUO Xin-gang, GAO Chang-cheng
Department of Orthopedics, Baoji High-Tech Hospital, Baoji 721000
Abstract 【Objective】To investigate the clinical effect of popliteal gastrocnemius internal and external head approach in the treatment of elderly patients with tibial plateau fractures involving the posterior column. 【Methods】A total of 98 elderly patients with tibial plateau fractures involving the posterior column from January 2012 to January 2020 was randomly divided into observation group and control group, with 49 cases in each group. The observation group was treated by internal and external head approach through popliteal gastrocnemius muscle, and the control group was treated by standard anterolateral approach. The tibial plateau varus angle and caster angle were measured by imaging examination. 12 months after operation, the curative effect was evaluated by Rasmussen radiology score, and the knee function and stability were evaluated by New York Special Surgery Hospital scoring system (HSS). The therapeutic effects of the two groups were compared. 【Results】There was no significant difference in average operation time and average intraoperative bleeding between the two groups (P>0.05). The postoperative hospital stay and fracture healing time in the observation group were shorter than those in the control group (P<0.05); There was no significant difference in tibial plateau varus angle and retroversion angle between the two groups immediately after operation, 1 month, 3 months, 6 months and 12 months after operation (P>0.05). The Rasmussen score of the observation group was (15.72±2.26), and the excellent and good rate was 100%. The Rasmussen score of the control group was (14.05±1.98), and the excellent and good rate was 91.84% (45/49). The Rasmussen score and excellent and good rate of the observation group were higher than those of the control group (P<0.05). 12 months after operation, the HSS score and knee range of motion in the observation group were higher than those in the control group (P<0.05); In the observation group, only one patient developed infection one month after operation and returned to normal after treatment. In the control group, one patient had joint stiffness and relieved after targeted rehabilitation training.【Conclusion】The internal and external head approach through popliteal gastrocnemius muscle is a safe and reliable method for the treatment of elderly patients with tibial plateau fractures involving the posterior column. The postoperative fracture healing is good and the knee function returns to normal.
LUO Xin-gang,GAO Chang-cheng. Clinical Observation of Internal and External Head Approach through Popliteal Gastrocnemius in the Treatment of Tibial Plateau Fractures Involving Posterior Column[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 48-51.
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2022, Vol. 39 
