Arc incision via double spatium intermuscular approach in the treatment of different types of fracture of posterolateral tibial plateau

LIU Wei-cai

Abstract：Objective To investigate the clinical effect of arc incision via double spatium intermuscular ap-proach in the treatment of different types of fracture of posterolateral tibial plateau.Methods A retrospective anal-ysis of clinical treatment and follow-up data of 60 cases of posterior tibial bone fractures with lateral platform collapse at our hospital from Jul.2010 to Jul.2012 were carried out.According to Schatzker fracture type,all patients were divided into SchatzkerⅢ +Ⅳgroup(28 cases) and SchatzkerⅤ +VI group(32 patients).Statistical data of in-traoperative performance and postoperative effects of patients in the two groups were analyzed.Results Operative time and blood loss of SchatzkerⅢ+Ⅳ group were significantly lower than those in SchatzkerⅤ+Ⅵ group( P<0.05 ) .The incision length,hospital stay,fracture healing time of two groups of patients had no significant difference ( P>0.05) .There was no significant difference of reduction distribution at 3 days after operation in the two groups ( P>0.05) .The excellent and good rate of reduction in SchatzkerⅢ+Ⅳgroup was 96.43%,higher than that in the SchatzkerⅤ+Ⅵ group(90.62%),but the difference was not significant(P <0.05).In the 3rd and 6th months,the Rasmussen and HSS score had no difference between Schatzker Ⅲ+Ⅳ group and SchatzkerⅤ+Ⅵgroup(P>0.05).But after the first 12 months,the Rasmussen Schatzker Ⅲ+Ⅳ group,HSS scores were signifi-cantly higher in SchatzkerⅤ+Ⅵgroup(P<0.05) during the last follow-up.During the last follow-up,the excel-lent and good rate of knee function in the SchatzkerⅢ+Ⅳgroup was 85.71%,higher than that of SchatzkerⅤ+Ⅵ(75%) group,but the difference was not significant(P>0.05).Conclusion Arc incision via double spatium in-termuscular approach in the treatment of different types of fracture of posterolateral tibial plateau can achieve good results and functional recovery after reduction.The postoperative knee function recovery in Schatzker Ⅲ+Ⅳ pa-tients is better than in typeⅤ+Ⅵ.