复杂性胫骨平台骨折的手术疗效分析

目的 探讨手术治疗复杂性胫骨平台骨折,Schatzker分型Ⅳ、Ⅴ和Ⅵ型骨折的疗效.方法 收集2003-2006年在我院行切开复位内固定治疗的复杂胫骨平台骨折36例患者资料进行回顾性分析,全部病例术前进行详细的手术设计,螺旋CT平扫及三维图像重建,制订手术方案,术中T或L型钢板固定.结果 随访10～23个月,平均18个月,按Merchant评分标准,优良率83.3%.结论 切开复位支撑钢板固定治疗复杂性胫骨平台骨折疗效满意.术前结合螺旋CT检查制定详细手术计划,术中力争解剖复位.足量植骨,坚强固定,术后完备的康复计划是手术成功的关键.

The effect of operation on complex fractures of tibial plateau

Objective To analyze the effect of operation on complex fractures of tibial plateau.Methods The data of thirty-six cases of complex tibial plateau fractures treated with open reduction and internal fixation were reviewed.All cases were carefully designed before operation and examined with spiral CT scanning and three-dimensional reconstruction.The scheme for operation was planned,and the operation was carried out with T or L shaped plate fixation.Results The follow-up period for patients was 10 to 23 months.Good result was obtained in 83.3 % cases according to the criteria of Merchant.Conclusion It is effective in treatment of patients with complex tibial plateau fractures by open reduction and internal fixation.In order to get better result,it is important to make a careful design before operation,regulate the rule of operation and make detail plan for exercise after operation.