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

摘要： ［摘要］ 目的 探讨两种手术入路内固定术对胫骨平台后内侧骨折（PMF?TP）的疗效影响。方法 选取2014年3月至2017年3月本院收治的PMF?TP患者80例，依据完成手术的不同路径，每组40例，常内组给予常规膝关节后内侧入路手术治疗，改内组给予改良髌旁内侧入路手术治疗，比较两组手术、并发症、骨折复位、膝关节功能情况。结果 改内组术中出血量、手术、住院、负重锻炼、骨折愈合时间明显低于常内组，差异有统计学意义（P<0.05）；改内组并发症率明显低于常内组，差异有统计学意义（P<0.05）；改内组术后6个月骨折复位、膝关节功能优良率明显高于常内组，差异有统计学意义（P<0.05）。结论 改良髌旁内侧入路较常规的后内侧入路相对简单且安全。

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