The Effect Of Fibular Neck Osteotomy Approach And Posterolateral Approach In The Treatment Of Posterolateral Tibial Plateau Fracture

Objective To explore the therapeutic effects of fibular neck osteotomy and posterolateral tibial plateau approach in the treatment of adult posterior lateral tibial plateau fracture,and to comprehensively compare the differences between them in various aspects,so as to guide the clinical work more clearly.Methods We adopt the method of retrospective study,a total of 43 patients with simple posterolateral tibial plateau who were treated by either the fibular neck osteotomy approach or the posterolateral tibial plateau approach in the Third Affiliated Hospital of Anhui Medical University from August 2017 to May 2020 were analyzed.Among them 20 cases were fibular neck osteotomy approach and 7 cases of ipsilateral fibular head or neck fracture.Posterolateral approach was used in23 cases.According to the set group,compared two groups of operation used time(min),intraoperative blood loss(ml),achieve bony healing time(week),knee functional score(Lysholm),postoperative fracture of tibial plateau score(Rasmusse),and postoperative complications after surgery.Results According to the cases of eligible patients included in our study.The follow-up time was 12 to 18 months.Among the surgical cases included in the study,no loosening or failure of the internal fixation was found in all cases,indicating good biocompatibility of the internal fixation device.Comparison the elapsed time of surgery,we found that the fibula neck bone cutting into the road group takes the average operation time was 85.92±18.63(min)and the posterolateral approach group time was 84.83 ±15.91(min),thus it can be seen,two groups of surgery on the time required to close(p > 0.05),surgical blood loss no difference(p > 0.05).There were more complications in the posterolateral group(p <0.05).There was no significant difference in Lyscholm functional score of knee joint 3 months after surgery(P>0.05).The reduction score of tibial plateau fracture(Rasmusse)3 months after surgery was higher in the osteotomy group(17.53±0.52)than in the posterolateral group(16.63±1.35)(P <0.05).Conclusion Both the fibular neck osteotomy and posterolateral tibial plateau approachcan effectively treat posterolateral tibial plateau fractures,but the fibular neck osteotomy approach can achieve better reduction and reduce the incidence of postoperative complications.Thereforeit is necessary to comprehensively select the appropriate approach depend on the fracture situation of physicians.