摘要
目的胫骨平台骨折伴膝关节面滑移是较为少见的损伤,现有的胫骨平台骨折分型系统不包括该型,相关的文献报道也很少见。文中报道我们利用外固定架联合有限内固定治疗胫骨平台骨折伴膝关节面滑移的经验。方法对15例胫骨平台骨折骨折患者采用外固定支架联合有限内固定方法进行治疗。结果术后X线片示骨折解剖复位11例,近解剖复位4例,随访时间6～12个月,平均10个月。拆除外固定后无骨折再移位,无术后感染、下肢深静脉血栓发生,10天左右骨折部位疼痛消失,3周后无压痛及纵轴叩击痛,3个月后X线示所有病例骨折均愈合。关节活动Rasmussen评分标准评定:优10例,良5例,优良率100%。结论外固定支架联合有限内固定治疗胫骨平台骨折合并膝关节滑移效果满意,有利于关节解剖复位、早期关节活动、减少骨与软组织损伤并发症。
Objective Tibial plateau fracture （TPF） with knee dislocation is an uncommon injury and unclassifiable accord- ing to the existing classification system of TPF, and relevant reports are rare. This article introduces our experience in the management of TPF with knee dislocation by external fixation combined with limited internal fixation. Methods We treated 15 cases of TPF with knee dislocation using the external fixator supplemented with limited internal fixation. Results The postoperative X-ray images re- vealed 11 cases of anatomic reduction and 4 cases of nearly anatomic reduction of the articular surface. The patients were followed up for 6 to 12 （mean 10） months. There were no major complications such as postoperative infection and deep venous thrombosis, nor oc- currence of re-dislocation after the lifting of the external fixator. Pain in the fracture site disappeared in about t0 days. Tenderness and pain at percussion of the vertical axis vanished after 3 weeks. X-ray examinations showed that the fractures were healed in all the cases after 3 months. Based on the joint activity Rasmussen assessment criteria, 10 cases achieved excellent and the other 5 cases good resuits. Conclusion External fixation supplemented by limited internal fixation may acheive satisfactory results in the treatment of tibial plateau fracture with knee dislocation, which contributes to anatomic reduction of the articular surface, early motion of the knee joint, and decrease of complications associated with bones and soft tissues.
出处
《医学研究生学报》
CAS
北大核心
2013年第1期38-40,共3页
Journal of Medical Postgraduates
基金
南京军区医学科技创新课题(08MA094)
关键词
胫骨平台骨折
膝关节滑移
手术治疗
Tibial plateau fracture
Knee dislocation
Surgical management
