摘要
目的探讨双钢板固定治疗胫骨平台SchatzkerⅥ型骨折的方法和临床疗效。方法回顾分析2007年5月至2010年3月收治的胫骨平台SchatzkerⅥ型骨折28例。术前CT扫描明确骨折具体部位、关节塌陷移位程度。所有病例均接受胫骨近端内外侧双钢板螺钉固定、自体髂骨植骨,3例结合克氏针辅助固定。结果 28例患者术后随访12～30个月(平均16.5个月)。骨折愈合时间平均为3个月,完全负重时间平均为3.6个月。术后1年根据美国纽约特种外科医院(HSS)膝关节功能评分评定疗效,优22例,良4例,中2例,优良率为92.9%。术后即刻胫骨平台内翻角、胫骨平台后倾角与术后1年相比,无统计学意义(P>0.05)。结论术前CT扫描对SchatzkerⅥ型胫骨平台骨折手术治疗具有明确指导作用。双钢板治疗可减少对胫前皮瓣和骨折端血供的破坏,坚强固定和良好植骨能避免关节面二期塌陷和膝关节力轴对线不良,早期合理的功能锻炼有助于提高疗效。
Objective To explore the clinical results of dual plates to treat the tibia] plateau fractures of Schatzker type Ⅳ Methods From May 2007 to March 2010, totally 28 patients with tibial plateau fractures of Schaztker type Ⅳ were admitted into our hospital. Through the CT scan, the specific parts of the fractures, the degree of collapse and displacement of the ar6cular surface were definited. All fractures were fixed with dual mediaHateral plates, combined with autogenous iliac bone graft. K-wires were also used to assist fixing the fractures in 3 patients. Results All patients were followed up from 12 to 30 months （16. 5 months in average）. The average time of radiographic bone union and full weight-bearing were 3 months and 3. 6 months, respectively. The Hospital for Special Surgery （HSS） knee score was adapted to measure the function of the patients at one year postoperatively, the results were excellent in 22 cases, good in 4 cases, medium in 2 eases, the excellent and good rate was 92. 9~. There was no difference in TPA and PA one year after surgery （P^0. 05）. Conclusions The CT scan has a clear role in guiding the treatment of tibia] plateau fractures. Dual plate can reduce the damage to the tibial anterior flap and the fracture blood supply. Strong fixation and autogenous iliac bone graft can avoid the collapse of the articular surface and the mechanical axis malalignment in the knee. Early reasonable functional exercise helps to improve the clinical result.
出处
《国际骨科学杂志》
2012年第2期129-131,共3页
International Journal of Orthopaedics
关键词
胫骨平台骨折
骨折内固定术
双钢板
临床疗效
Tibial fractures
Fracture internal fixation Bilateral plate
Treatment outcome
