双切口双钢板加植骨治疗高能量胫骨平台骨折

目的研究双切口双钢板加植骨治疗高能量胫骨平台骨折的临床疗效。方法自2002年3月至2007年3月，对我院收治的32例高能量胫骨平台骨折患者，采用双切口双钢板加植骨的方法进行手术治疗，所有患者术后第1天起即进行膝关节功能锻炼。结果所有患者均获8～36个月随访，平均19．4个月。骨折均获骨性愈合。膝关节功能采用Merchant评分标准评定，优20例，良9例，可3例，优良率90．6％。结论采用双切口双钢板加植骨治疗高能量胫骨平台骨折，应用微创技术避免对胫前皮瓣和骨折端血供过分破坏、正确选择手术时机、术中良好的复位固定和植骨、早期恰当的功能锻炼可提高胫骨平台骨折的疗效。

Double Plates Fixation and Bone Graft in the Treatment of High-energy Fractures of Tibial Plateau

Objective To evaluate the clinical effects of treatment of high-energy fractures of tibial plateau with two incisions ,double plates fixation and bone graft. Methods From Match 2002 to March 2007,32 patients with high-energy fractures of tibial plateau received surgical treatment with two incisions,double plates fixation and bone graft in our hospital. Exercises to recover the function of knee joint went on gradually from the first day after operation for all the cases. Results All cases were followed up for 8～36 months. All the fractures healed satisfactorly. According to Merchant evaluation system,the knee function was excellent in 20 cases ,good in 9 cases,and fair in 3 cases. The excellent and good rate was 90.6%. Conclusion The treatment of high-energy fractures of tihial plateau with two incisions,double plates fixation and bone graft can avoid damaging the blood supply to the pre-tibial skin flap and the fracture ends. Good timing of surgery ,correct reduction and bone graft ,and early right functional exercise will enhance the curative effects of the tihial plateau fracture.