摘要
目的探讨联合入路双钢板或三钢板内固定治疗胫骨平台骨折(SchatzkerⅤ、Ⅵ型)的临床疗效。方法选取2010年3月~2014年3月我院收治的40例胫骨平台骨折(SchatzkerⅤ、Ⅵ型)患者,年龄18~65岁,平均38.9岁;Schatzker分型:Ⅴ型29例、Ⅵ型11例;AO分型:41-C1型8例,41-C2型2例,41-C3型30例。根据患者的伤情选择Ⅰ期外固定支架固定,Ⅱ期内固定或直接内固定治疗。观察术后骨折愈合情况、膝关节活动度及膝关节HSS评分。结果40例患者术后,随访12~38个月,平均18.7个月,骨折愈合时间为3~7个月,平均4.9个月。术后1年时膝关节活动度:屈膝70~122度,平均93.7度,伸膝0~30度,平均6.4度,膝关节HSS评分60~92分,平均81.4分。术后所有所有患者的胫骨力线恢复正常,双下肢长度差不超过1cm,有2例患者发生畸形愈合,3例患者发生切口坏死。结论对胫骨平台骨折(SchatzkerⅤ、Ⅵ型)手术前应根据骨折情况制定手术方案,突出分期性和个体化,采取联合入路充分显露视野,尽可能恢复下肢力线、长度和关节面的平整,并同时给予双钢板或三钢板坚强固定,可以获得满意的疗效。
Objective To evaluate the curative effect of fracture of tibial plateau（Schatzker Ⅴ Ⅵ type） treated by joint approch double or three steel plate internal fixation. Method 40 patients with tibial plat plateau fractures （Schatz- key Ⅴ , Ⅵ type） were involved in the presend study including 22 men and 18 women. Their age was 18-65 years （average 38.9 years）. There were 29 caes with Schatzkev Ⅴ type and 11 cases with Schatzkev Ⅳ type. The patients were treated with Ⅰ period fixation, Ⅱ period internal fixation or direct internal fixation. The healing situation, knee joint mobility and knee joint HSS score were observed. Results All of the patients were followed up for 12-38 months. Fcture healing time was 3-7 month. The knee flexion 1 year after operation was 70-122°. The knee extensioin 1 year after operation was 0-30°. The knee HSS score was 60-92 points. The tibial force line was normal after ooperation. The difference of the two lower limbs length was less than 1era. There were 2 patients with malunion, and 3 patients with incision necrosis. Conclusion The tibial plateau fractures （Schatzker Ⅴ , Ⅵ type） should make operation plan based on the fracture operation situation before the operation, highlight the staging and individualization, fully show the vision, recover the lower limb power line, the length and the articular surface as far as possible, and give two or three steel plate internal fixation.
出处
《西部医学》
2015年第8期1226-1229,共4页
Medical Journal of West China
关键词
胫骨平台骨折
联合入路
内固定
Tibial plateau fractures ~ Approch^Internal fixation
