根据改良的Schatzker分型治疗复杂胫骨平台骨折

目的探讨改良的Schatzker分型对复杂胫骨平台骨折制定术前计划的指导作用,使术前计划更充分,减少术中误判。方法 2006年3月至2013年10月,对58例需要切开复位及内固定的常规SchatzkerⅤ型、Ⅵ型胫骨平台骨折,随机分成对照组及实验组,每组29例,对照组进行Schatzker分型,实验组进行改良的Schatzker分型,并分别确定手术入路、内固定物放置位置及数量,比较两种分型对手术进路、内固定物放置位置及数量的正确率,比较两种分型对指导治疗方案的满意度。结果根据改良的Schatzker分型,对SchatzkerⅤ型、Ⅵ型骨折患者进行手术入路选择,确定内固定物放置位置及数量,进行术前计划和术中观察,对关节面的复位及主要问题骨的显露和直接固定的正确率为100%,而根据常规Schatzker分型,对SchatzkerⅤ型、Ⅵ型胫骨平台骨折选择手术入路、内固定物放置位置及数量,正确率为86.36%,差异有统计学意义。结论根据改良的Schatzker分型,对需要切开复位及内固定的复杂胫骨平台骨折,选择手术入路及内固定物放置位置及数量更准确,使术前计划更充分,减少术中误判,术中证明对关节面及主要问题骨的复位更好,对主要问题骨的固定更直接,更准确。

Operation of Tibial Plateau Fractures According to Improved Schatzker Classification

Objective To observe the guiding effect of improved Schatzker type on inner fixxing position and amount of tibial plateau fractures,so as to make a full preoperative programme and reduce misjudgement. Methods From March 2006 to October 2013,58 cases with tibial plateau fractures were examined and classified by Schatzker type 5 and 6,and then reclassi_fied once more according to improved Schatzker typing. and then made the operation path,and fixing position and amount. The accuracy was more satisfying. Results Based on improved Schatzker type,the accuracy of operation path,and the inner fixing position and amount was 100% . While the accuracy of operation path,and the inner fixing position and amount was about 86. 36% . There was significant difference between improved Schatzker and control groups. Conclusion It is direct and accurate to reduct and fix the tibial plateau fractures using improved Schatzker Type.