关键词: 改良髌旁内侧入路, 后内侧入路, 胫骨平台后内侧骨折

Abstract: ［Abstract］ Objective To discuss the effect of two internal fixation on posteromedial fracture of tibial plateau （PMF?TP）. Methods Eighty patients with PMF?TP were selected from March 2014 to March 2017 in our Hospital. According to different surgical approaches， the patients were divided into two groups， posteromedial approach group （40 cases） and parapatellar anteromedial approach group （40 cases）. The former was treated with routine posteriormedial approach of knee joint， the later was treated with improved parapatellar anteromedial approach. The operation， complications， fracture reduction and knee joint function of the two groups were compared. Results The intraoperative blood loss， operation， hospitalization， weight bearing exercise， fracture healing time and incidence of complications of parapatellar anteromedial approach were significantly lower than those of the posteriormedial approach， and the difference was statistically significant （P<0.05）. The fracture reduction and knee joint function excellent rate 6 months after operation of posteriormedial approach group were significantly higher than those of the parapatellar anteromedial approach， and the difference was statistically significant （P<0.05）. Conclusion The modified medial parapatellar approach is simpler and safer than the conventional posteromedial approach.

Key words: posteromedial fracture of tibial plateau, improved parpatellar anteromedial approach, posteromedial approach