| 胫骨平台骨折术后行内固定翻修的治疗策略 |
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| 引用本文： | 施鸿飞,熊进,陈一心,王骏飞,邱旭升,邱勇. 胫骨平台骨折术后行内固定翻修的治疗策略[J]. 中国矫形外科杂志, 2011, 19(20): 1682-1685 |
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| 作者姓名： | 施鸿飞 熊进 陈一心 王骏飞 邱旭升 邱勇 |
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| 作者单位： | 南京大学医学院附属鼓楼医院骨科,210008 |
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| 基金项目： | 国家自然科学基金(编号:30901570); 南京市青年科技人才启动项目(编号:QYK10147) |
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| 摘 要： | [目的]探讨胫骨平台骨折术后行内固定翻修的指征、策略和临床效果.[方法]回顾2006年10月～2009年9月收治的胫骨平台骨折术后患者23例,均为首次术后4～12周症状改善不佳或出现内固定失败后来本院就诊.术前Schatzker分型Ⅳ型6例,V型7例,Ⅵ型10例.入院后评估首次手术的不足并制定个体化的翻修手术方案.术中对骨折行重新复位,调整关节面和膝关节力线,并选择恰当的锁定或非锁定接骨板对内侧、外侧及后侧骨块进行充分固定.术后视膝关节稳定程度尽早开始功能锻炼.[结果]术后未发生感染、深静脉血栓等早期并发症.随访骨折均愈合良好,平均愈合时间为12.7周,未发现复位丢失和内固定失败.术后12个月膝关节功能评分(HSS)达77.9,较术前明显改善(P=0.000).[结论]笔者认为胫骨平台骨折术后翻修的指征包括严重的关节面塌陷(>5mm)、膝关节力线不良(胫骨平台内翻角≧95°或≦80°)以及固定不充分.针对性的翻修手术辅以术后早期功能锻炼可获得良好的治疗效果.
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| 关 键 词： | 胫骨平台骨折 并发症 翻修手术 内固定 |
Revision surgery for failed reduction and internal fixation of tibial plateau fractures |
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| SHI Hong-fei,XIONG Jin,CHEN Yi-xin,et al.. Revision surgery for failed reduction and internal fixation of tibial plateau fractures[J]. Orthopedic Journal of China, 2011, 19(20): 1682-1685 |
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| Authors: | SHI Hong-fei XIONG Jin CHEN Yi-xin et al. |
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| Affiliation: | SHI Hong-fei,XIONG Jin,CHEN Yi-xin,et al.Department of Orthopaedics,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China |
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| Abstract: | [Objective] To analyze the indication,strategy and clinical outcome of the revision surgery for failed reduction and internal fixation of tibial plateau fractures.[Method]Totally 23 cases were reviewed between Oct 2006 to Sep 2009.All the patients(6 cases of Schatzker type IV,7 cases of type V,and 10 cases of type VI) were admitted after a failed primary surgery 4 to 12 weeks ago.Personalized revision surgeries were planned according to the potential reasons of failure.Specifically,the joint surface was red... |
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| Keywords: | tibial plateau fracture complication revision surgery internal fixation |
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