复杂性胫骨平台骨折13例手术治疗失败的原因分析

目的探讨复杂胫骨平台骨折手术治疗失败的原因。方法回顾性分析2002年3月至2010年4月13例手术治疗失败的复杂性胫骨平台骨折资料,分析手术失败的原因。结果开放性损伤和C3型骨折术后发生治疗失败率高于闭合性和C1和C2型骨折,差异具有统计学意义(P﹤0.05)。良好的复位和充分植骨可有效提高手术成功率。术前未行CT或MRI检查者与术前充分检查者手术失败率对比差异具有统计学意义(P﹤0.05)。17例手术时机不成熟,术后2例出现手术失败,失败率为11.8%,高于成熟组的3.38%(P﹤0.05)。结论损伤程度、复位、植骨、术前充分检查以及手术时机是引起复杂性胫骨平台骨折术后手术失败的危险因素。

Cause analysis of 13 cases of complex tibial plateau fracture surgery failure.

Objective To analyze the cause of failure of the surgical treatment of complicated tibial plateau fracture. Methods The data 13cases with complicated tibial plateau fracture with treatment failure was reviewed to explore the reasons. Results There was significant difference between patulous injury and blunt abdominal injury, and between CI type and C2 C3 fracture （ P 〈 O. 05 ）. The higher successful treatment were happened in that patients with good restoration and bone grafting. The result shows higher successful treatment rate in those re- ceived sufficient examination and have right operative opportunity. There were significant difference in those with sufficient examination compa- ring with those without sufficient examination. 17 patients did not have good operation opportunity. 2 of 17 patients had failure operation and the failure rate is 11.8 %. The failure rate is higher than those with good operation opportunity of 3.38 % （ P 〈 0.05 ）. Conclusion The risk fac- tor in failure of the surgical treatment of complicated tibial plateau fracture are injury degree, and restoration technique, and bone grafting, and examination, and operative opportunity.