Observation Of The Curative Effect Of Posterior Lateral Tibial Plateau Fracture With Gerdy Tuberosity Lateral Osteotomy Plate Combined With Anterior And Posterior Lag Screw Fixation

Objective: To study the treatment effect of lateral tibial plateau fracture after treatment with Gerdy tuberosity lateral osteotomy plate combined with front and back lag screw fixation,and then compare with Gerdy tuberosity lateral osteotomy approach combined with plate therapy,in order to Good treatment lays the foundation.Methods: Retrospective analysis of the clinical data of 23 patients with posterolateral tibial plateau fractures treated with Gerdy tubercle lateral osteotomy plate combined with anterior and posterior lag screw fixation from January 2015 to January 2019 in our hospital,including 19 males and 20 females,An average of 45±5.9years old,are all closed fractures,the cause of injury: 16 cases of falling injuries from high places,23 cases of traffic accident injuries.Fractures were classified according to Schatzker:28cases of type II and 11 cases of type III.Check X-rays,CT and 3D reconstruction before treatment.The time between the patient’s illness and the operation is 4 to 12 days,with an average of 7 days.Among all the patients,29 patients received anatomical reduction through fracture and 10 patients received normal reduction.All incisions healed after operation.All patients observed were followed up for 12 to 18 months.All patients healed 6 to 9 months after the operation and were not accompanied by adverse reactions such as neurological symptoms,blood vessel destruction,joint stiffness,and inflammation.Use X-ray to determine the patient’s recovery after operation,and follow up the patient’s knee joint mobility(ROM)and the degree of articular surface collapse at 12 months after operation to further determine the efficacy and pass the hospital for special surgery,HSS)score to evaluate the degree of knee recovery.Results: All patients were followed up.Observe the X-rays after the operation.It was found that the boundary of the fracture line was unclear after 3 months and disappeared completely after 12 months.At the last follow-up,knee ROM stretched0 ° ~ 2 °,flexion 125 ° ~ 135 °,HSS knee function score was 93.6 ±0.9,the difference was statistically significant(P < 0.05),the degree of articular surface collapse was 1.21 ± 0.9 mm,The difference was statistically significant(P<0.05).The knee joint mobility(ROM)and the degree of articular surface collapse were compared with the Gerdy tubercle lateral osteotomy approach combined with the effect of the steel plate to evaluate the quality of fracture reduction.The hospital for special surgery(HSS)scores for knee function were all evaluated.Better than the control group.All patients were placed drainage tube after operation.There was no incision infection after operation,the incision reached stage I / nail healing,and no complications such as joint instability and infection.Conclusion: After the treatment method of Gerdy tuberosity lateral osteotomy approach combined with plate screw fixation system,it was found that the articular surface can be reduced.Compared with the traditional treatment method,the increase of the front and back screws can be fixed more firmly,and it is appropriate to perform after the operation is completed.The functional rehabilitation exercise reduces the occurrence of adverse reactions,so we believe that the therapy has better therapeutic effects and is worthy of universal application.