锁定加压钢板治疗复杂性胫骨平台骨折

目的报告锁定加压钢板治疗复杂性胫骨平台骨折的方法及临床疗效。方法 2006年1月～2009年1月,采用开放复位、锁定加压钢板内固定治疗复杂性胫骨平台骨折39例,其中男22例,女17例;年龄18～50岁,平均37岁。骨折按Schatzker分型法,Ⅳ型14例,Ⅴ型19例,Ⅵ型6例。术后随访时间12～18个月,平均14个月,根据影像学检查结果、膝关节屈伸活动度及Rasmussen评分标准进行临床疗效评定。结果术后12个月按Rasmussen膝关节评分标准,优26例,良7例,可4例,差2例,优良率84.6%。发生人工骨反应1例,皮瓣坏死1例,开放性骨折感染1例。无螺丝钉松动、断裂及内固定失败发生。结论锁定加压钢板治疗复杂性胫骨平台骨折复位满意,固定牢靠,操作简单,创伤较少,具有疗效佳、康复快、功能好等优点,是手术治疗复杂性胫骨平台骨折安全、有效的内固定方法之一。

Locking Compression Plate for the Treatment of Complex Tibial Plateau Fractures

Objective To report the methods and clinical effects of locking compression plate for the treatment of complex tibial plateau fractures.Methods From January 2006 to January 2009,39 patients with tibial plateau fractures,including 22 males and 17 females,were treated with surgical reduction and internal fixation with locking compression plate.The mean age of the patients was 37 years（18 ～ 50 years）.According to Schatzker classification,there were 14 cases of type Ⅳ,19 cases of type Ⅴ,6 cases of type Ⅵ.The follow-up period ranged from 12 to 18 months with a mean of 14 months.The clinical results were assessed according to radiological examination,ranges of motion and Rasmussen evaluation system.Results According to the Rasmussen knee score standard,26 cases were excellent,7 cases were good,4 cases were fair and 2 cases were poor at 12 months postoperatively and the satisfactory rate was 84.6%.One case occurred artificial bone reaction.One case occurred skin flap necrosis.One case occurred wound infection in open fracture.No screw sliding,dislodging and fixation failure were found during follow-up.Conclusion In the treatment of complex tibial plateau fractures,locking compression plate not only maintains satisfying reduction with reliable fixation,but also manipulates simply and invades slightly,thus gets good curative effect,fast recovery,satisfying function and so on.So it is one of the effective fixation techniques for the treatment of complex tibial plateau fractures.