| 宋林涛,贾代良.胫骨平台后外侧骨折的手术入路研究进展[J].济宁医学院学报,2025,48(6):556-561 |
| 胫骨平台后外侧骨折的手术入路研究进展 |
| Advances in surgical approaches for posterolateral tibial plateau fractures |
| 投稿时间：2025-08-19 |
| DOI：10.3969/j.issn.1000-9760.2025.06.013 |
| 中文关键词: 胫骨平台骨折;后外侧;手术入路 |
| 英文关键词: Tibial plateau fracture;Posterolateral;Surgical approach |
| 基金项目:济宁市重点研发计划(2024YXNS243) |
| 作者 | 单位 | E-mail | | 宋林涛 | 济宁医学院临床医学院(附属医院), 济宁 272013 | | | 贾代良 | 济宁医学院临床医学院(附属医院), 济宁 272013
济宁医学院附属医院急诊外科, 济宁 272029 | 237849399@qq.com |
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| 中文摘要: |
| 胫骨平台后外侧骨折所处解剖位置深在,且骨折块隐匿,常导致术中视野暴露不充分、操作空间受限。为提升视野显露效果、促进骨折解剖复位与固定,临床上陆续发展了多种手术入路。目前,手术入路的选择仍存争议,核心问题集中于微创入路与扩大显露入路之间的取舍,以及是否联合截骨策略以获取更佳操作视野。本文基于近年来的相关文献,系统梳理了后外侧、后正中、前外侧、腓骨小头上入路等非截骨入路,以及腓骨颈截骨、腓骨头截骨、股骨髁上截骨及Gerdy结节截骨等截骨入路的适应证、技术要点与临床效果,并对未来个体化入路选择与精准手术技术的发展方向进行展望。 |
| 英文摘要: |
| Posterolateral tibial plateau fractures are characterized by their deep anatomical location and occult fracture fragments,which often lead to inadequate intraoperative exposure and limited operational space.To improve visual exposure and facilitate anatomical reduction and stable fixation of the fracture,various surgical approaches have been developed in clinical practice.However,the selection of surgical approaches remains controversial,with the core issue centering on the trade-off between minimally invasive approaches and extended exposure approaches,as well as whether to combine osteotomy strategies to achieve better operational visibility.Based on recent relevant literature,this article systematically reviews non-osteotomy approaches,such as the posterolateral,posterior midline,anterolateral,and suprafibular head approaches,as well as osteotomy approaches,including fibular neck osteotomy,fibular head osteotomy,supracondylar femoral osteotomy,and Gerdy's tubercle osteotomy,in terms of their indications,technical key points,and clinical outcomes.Additionally,it offers prospects for the future development of individualized approach selection and precise surgical techniques. |
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