摘要
目的:观察可注射型人工骨结合支持钢板手术重建塌陷型SchatzkerⅡ、Ⅲ型胫骨平台骨折的疗效。方法:2005年6月至2008年1月,采用注射型硫酸钙人工骨结合支持钢板手术重建21例塌陷型SchatzkerⅡ、Ⅲ型胫骨平台骨折患者,男16例,女5例;年龄27～62岁,平均35.3岁;病程3～7d,平均4d。按Schatzker分类标准:Ⅱ型骨折17例,Ⅲ型骨折4例。全部病例术前均行X线摄片、CT扫描及三维重建,以准确了解骨折的塌陷和粉碎程度及骨折碎片的翻转方向。凡骨折塌陷>3mm,且伤前无关节退行性变者,均作为该手术方法的适应证。术后采用膝关节Lysholm评分标准进行辅助评价观察术后骨折愈合和膝关节功能的恢复情况。结果:21例获随访,时间6个月～2.5年,平均1.5年,进行X线片和功能随访,显示所有骨折均达到解剖复位或接近解剖复位;1例Ⅱ度严重粉碎性骨折术后6个月发生高度丢失,平台复位效果不佳。Lysholm评分(88.3±5.2)分,优12例,良7例,一般2例。结论:微创可注射型硫酸钙人工骨结合支撑钢板手术重建塌陷型SchatzkerⅡ、Ⅲ型胫骨平台骨折能有效避免复位后的再丢失,改善远期疗效,微创可注射型硫酸钙人工骨作为骨移植替代材料,具有良好的临床应用前景。
Objective：To observe the effective of the injectable artificial bone combined with plate fixation for reconstructing the collapse tibial plateau fracture.Methods：From June 2005 to January 2008,21 cases of collapse tibial plateau fracture of type SchatzkerⅡ,Ⅲwere treated by injectable calcium sulfate bone substitute combined with supportive plate reconstruction including 16 males and 5 females with an average age of 35.3 years ranging from 27 to 62 years.The disease course was from 3 to 7 days（means 4 days）.According to Schatzker classification,there were 17 cases of typeⅡ,4 of typeⅢ.All patients preoperatively underwent radiography,CT scanning and three dimensional reconstruction in order to accurately understand the extent of fracture and fracture collapse and the shattered fragments of the flip direction.All the fracture with collapse3 mm,without joint degeneration were selcected for surgical treatment.The knee joint function after fracture healing and recovery were evaluated by Lysholm scoring.Results：All patients were followed up for from 6 months to 2.5 years（means 1.5 years）.The X ray films and features of all fractures showed anatomic reduction or near anatomic reduction,except one case of grade Ⅱ severe comminuted fracture occurred a high degree of loss and platform reset ineffective after 6 months.The Lysholm scoring of knee function showed that the mean score was（88.3±5.2）.The resutls were excellent in 12 cases,good in 7 cases,fair in 2 cases.Conclusion：Minimally invasive injectable calcium sulfate bone combined with plate fixation for reconstructing the collapse tibial plateau fracture of type Ⅱ,Ⅲ can effectively prevent the further loss after reduction,to improve the long term results.Minimally invasive injectable calcium sulfate as an artificial bone substitute materials has good prospects for clinical application.
出处
《中国骨伤》
CAS
2010年第6期431-434,共4页
China Journal of Orthopaedics and Traumatology
关键词
胫骨骨折
骨替代品
骨折固定术
内
Tibial fractures
Bone substitutes
Fracture fixation
internal
