48例高能量胫骨平台骨折的治疗对策和疗效分析 |
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引用本文: | 孙炜,刘安庆,向香成,李美才. 48例高能量胫骨平台骨折的治疗对策和疗效分析[J]. 实用全科医学, 2009, 7(2): 138-139 |
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作者姓名: | 孙炜 刘安庆 向香成 李美才 |
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作者单位: | 广东省深圳市第二人民医院骨科,518035 |
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摘 要: | 目的探讨高能量胫骨平台骨折的手术时机、手术方法和临床疗效,分析影响疗效的因素。方法对48例高能量胫骨平台骨折患者,根据Schatzker分型:Ⅳ型11例,Ⅴ型20例,Ⅵ型17例。术前均行X片、CT检查,必要时行膝关节MRI检查。所有病例均采用切开复位,植骨及钢板内固定。术后早期进行连续被动运动(Continous Passive Motion,CPM)功能锻炼。结果所有病例术后获得6个月-3年,平均22.8个月的随访。无骨折不愈合和畸形愈合。临床骨愈合时间平均为16.6周。膝关节屈曲110°~135°,1例出现轻度膝关节内翻。采用改良的Rasmussen评分标准评价膝关节功能:优27例,良16例,可5例。优良率为89.6%。结论对于由高能量导致的胫骨平台骨折患者,手术治疗能达到令人满意的疗效。稳定的内固定,充分的植骨,同时术中尽可能减少对骨折血运的干扰,保护膝关节的附属结构,术后早期功能锻炼,将明显改善疗效,减少并发症。
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关 键 词: | 胫骨平台 骨折 疗效 |
Surgical Treatment and Clinical Analysis of 48 Cases of Tibial Plateau Fracture |
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Affiliation: | SUN Wei, LIU An-qing, XIANG Xiang-cheng, et al.( Department of Orthopaedics Surgery, Shenzhen Second Hospital, Guangdong 518025, China) |
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Abstract: | Objective To investigate the best operation opportunity, operation methods and the effect of treatment on tibial plateau fracture. Methods From January 2003 to January 2006,48 cases with tibial plateau fracture including 11 cases of Schatzker type Ⅳ ,20 of typeV and 17 of type Ⅵ were measured with X-ray ,CT scan and MRI scan before operation. All cases were treated with open reduction, internal fixation with buttress plates or autologous bone graft and continuous passive motion(CPM) function rehabilitation after operation. Results All cases were followed up form 6 to 36 months,with an average period of 22.8 months. No nonunion or malunion were found in all cases. The mean time for bone union was 16.6 weeks. The flexion of the knee achieved form 110°-135° except 1 case knee enstrophe. The knee function was excellent in 27 cases, good in 16 cases and fair in 5 cases, with the excellent and good rate was 89.6% according to the Rasmussen evaluation system. Conclusion In treatment of tibial plateau fracture, direct open reduction, stable internal fixation with inboard and outboard buttress plates or abundant autologous bone graft in bone defects, minimal invasion to the blood supply of fracture segments, a good protection of the knee joint structure, and early function rehabilitation would ameliorate curative effect and reduce syndrome significant. |
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Keywords: | Tibial plateau Fracture Curative effect |
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