两种内固定方式治疗Schatzker Ⅳ型胫骨平台骨折后外侧柱损伤的疗效比较

doi:10.3969/j.issn.1006-5725.2025.18.012

Abstract

Abstract:

Objective To compare the clinical outcomes of two internal fixation methods for the treatment of lateral column injuries following Schatzker type Ⅳ tibial plateau fractures with posterior lateral displacement of bone fragments. Methods A retrospective analysis was performed on the clinical data of 61 patients who underwent surgical treatment for lateral column injuries associated with Schatzker type Ⅳ tibial plateau fractures at the institution between March 2019 and August 2024. Of these patients， 34 who were treated with isolated lateral plating were allocated to the experimental group， and 27 who received combined fixation using a posterior T-plate and lateral plate were assigned to the control group. Results Both groups showed no incidence of grade C wound healing following surgery. The experimental group demonstrated a grade A wound healing rate of 94.1%， which was significantly higher than that of the control group （70.4%）. The surgical duration in the experimental group was significantly shorter ［（83.8 ± 8.5） minutes］ compared to the control group ［（115.7 ± 11.2） minutes］. Additionally， the postoperative hospital stay was shorter in the experimental group ［（12.5 ± 3.1） d］ than in the control group ［（14.9 ± 3.2） d］. The intraoperative blood loss in the experimental group ［（271.0 ± 51.3） mL］ was also significantly lower than that in the control group ［（308.5 ± 60.1） mL］， and the difference was statistically significant （P < 0.05）. No statistically significant difference was observed in fracture healing time between the two groups （P > 0.05）. At the final follow-up， no statistically significant differences were found in KSS or VAS scores between the two groups （P > 0.05）. Conclusions Both the simple lateral plate fixation method and the posterior T-shaped plate combined with lateral plate fixation method are applicable for the treatment of Schatzker type Ⅳ tibial plateau fractures involving posterior-lateral column injuries. However， the simple lateral plate fixation method is associated with shorter surgical duration， reduced hospitalization， less intraoperative blood loss， and a higher rate of incision healing.

Key words: tibial plateau fracture, Schatzker type Ⅳ fracture, anterolateral approach, posteromedial approach, posterolateral column, comparative study

CLC Number:

Tianyu ZHANG,Lei WANG,Hui WANG,Jun LI. The efficacy comparison of two kinds of internal fixation methods for treating Schatzker type Ⅳ tibial plateau fractures with lateral column injury[J]. The Journal of Practical Medicine, 2025, 41(18): 2865-2870.

Figures/Tables 5

Tab.1

Comparison of preoperative general data between the two groups of patients"

指标	观察组（n = 34）	对照组（n = 27）	$χ 2$ /t值	P值
性别（男/女）	20/14	17/10	0.108	0.742
年龄（x ± s）/岁	43.6 ± 1.4	44.0 ± 0.9	1.413	0.163
受伤原因（交通伤/摔伤）	12/22	11/16	0.190	0.663
受伤部位（左/右）	18/16	18/9	1.172	0.279
受伤至手术时间（x ± s）/d	12.6 ± 1.2	12.6 ± 0.5	0.831	0.411

Tab.1

Tab.2

Tab.3

Fig.1

Fig.2

References 21

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指标	观察组（n = 34）	对照组（n = 27）	t值	P值
手术时间/min	83.8 ± 8.5	115.7 ± 11.2	12.588	< 0.001
术中出血量/mL	271.0 ± 51.3	308.5 ± 60.1	2.629	0.011
切口愈合等级（甲/乙）/例	32/2	19/8	6.192	0.013
术后住院时间/d	12.5 ± 3.1	14.9 ± 3.2	2.917	0.005
骨折愈合时间/月	4.0 ± 1.4	3.5 ± 1.1	1.658	0.094

指标	观察组（n = 34）	对照组（n = 27）	t值	P值
KSS评分	170.7 ± 1.4	170.1 ± 1.3	1.872	0.072
疼痛VAS评分	1.0 ± 0.3	0.9 ± 0.3	0.728	0.469

The efficacy comparison of two kinds of internal fixation methods for treating Schatzker type Ⅳ tibial plateau fractures with lateral column injury

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