摘要
[目的]提高胫骨平台骨折的治愈率,降低伤残率。[方法]对126例胫骨平台骨折进行回顾性分析,平均随访20个月。探讨临床分型、治疗措施与预后的关系。[结果](1)本组126例,优86例,良21例,可14例,差5例,优良率84.9%;(2)Ⅰ型、Ⅱ型、Ⅲ型各自的优良率为95.45%、83.3%、62.5%,P<0.01:(3)保守与手术治疗的优良率分别为91.5%、79.1%,P<0.05;(4)手术患者解剖复位与非解剖复位的优良率分别为85%、70.37%,P>0.05。[结论](1)劈裂分离<5 mm、塌陷移位<3 mm的骨折仍可保守治疗,不宜任意扩大手术适应证;(2)手术复位残留<3 mm的塌陷,不影响功能恢复,不宜一味追求解剖复位;(3)内固定材料的选择以固定可靠、对组织剥离少、保护骨折部和皮肤的血运为原则;(4)尽可能保留半月板;(5)疗效与骨折的类型有关。
[ Objective] To increase the cure rate and decrease the disabilities rate of tibial plateau fracture. [ Method ] The clinical classification, management, and prognosis of tibial plateau fracture were studied by following 126 cases in 20 months. [Result] （ 1 ） 126 cases were followed and the result was： excellent： 86 cases,good： 21 cases, acceptable： 14 cases, bad： 5 cases. The cure rate was 84.9 %. （2） The cure rates of type Ⅰ , Ⅱ and Ⅲ were 95.45% ,83.3% ,62.5% （P 〈0.01 ）. （3） The cure rates of conservative and operative managements were 91.5 % ,79.1% （ P 〈 0. 05 ）. （ 4 ） The cure rates of anatomical reduction and non - anatomical reduction were 85 % ,70.37 % （ P 〉0.05 ）. [ Conclusion] （ 1 ） Displaced fracture with vertical split 〈 5 mm, depression 〈 3 mm can also be managed by means of conservative management, does not magnify the use of operation. （2） Displaced fracture with depression 〈 3mm after operation is acceptable, it is not necessary to achieve anatomical reduction. （3） Criteria of internal fixation devices： should be fit in shape and size, of minimal destruction to soft tissues and blood supply to the broken ends and the skin. （4）To preserve the meniscus as long as possible. （5）Prognosis is dependent to the type of fracture.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第10期740-742,i0002,共4页
Orthopedic Journal of China
关键词
骨折
胫骨平台
治疗
Fracture
Tibia plateau
Treatment
