胫骨平台骨折手术治疗的体会

目的探讨胫骨平台骨折手术治疗的方法。方法对1998～2006年在我院治疗的胫骨平台骨折进行手术治疗。骨折按Sehaezker分类方法分型：Ⅰ型15例，Ⅱ型9例，Ⅲ型11例，Ⅳ型5例，Ⅴ型2例，Ⅵ型1例。Ⅰ、Ⅲ、Ⅳ型采用植骨＋松质骨螺钉＋支撑钢板内固定治疗。Ⅱ型复位关节面后，采用植骨＋松质骨螺钉＋支撑钢板内固定治疗。Ⅴ、Ⅵ型骨折复位后，采用植骨＋松质骨螺钉＋内、外侧双支撑钢板内固定治疗。结果对43例患者术后随访10～24个月，按照Rasmussen检测标准对膝关节功能恢复情况进行评价，优30例（69．77％），良9例（20．93％），差4例（9．3％）。结论手术治疗胫骨平台骨折需坚强的内固定、积极早期处理合并伤、早期的膝关节功能锻炼。

Surgical Treatment of the Tibial Plateau Fracture

Objective To investigate surgery treatment methods of the tibial plateau fracture. Methods From 1998 to 2006 in our hospital tibial plateau fracture were treated with surgery. Schaezker fracture classification by type： 15 cases of Type Ⅰ, 9cases of Type Ⅱ , 11 cases of Type Ⅲ, 5 cases of Type Ⅳ,2 cases of TypeⅤ, 1cases of TypeⅥ. Ⅰ, Ⅲ, Ⅳ use of cancellous bone graft ＋ support plate screws for the treatment. II Type reduction articular surface, a cancellous bone graft ＋ support plate screws for the treatment. V, VI fracture reduction, the use of cancellous bone screws ＋ the dual-lateral plate for support. Results 43 patients were followed up after 10 to 24 months, according to Rasmussen standard right knee function to evaluate the situation, gifted 30 cases （69.77%）, good in nine cases （20.93%） and poor in 4 cases（9.3%）. Conclusion Surgical treatment of tibial plateau fracture fixation need a strong, active early treatment with injured knee early functional training.