影响胫骨平台骨折手术疗效因素分析

目的探讨胫骨平台骨折疗效的影响因素，提出相应对策。方法对2001年1月至2005年12月我院收治188例胫骨平台骨折手术治疗患者进行回顾分析。结果127例得到随访，随访时间6个月-5年，平均27．6个月，17例出现并发症，发生率为13．38％。其中：复位不良3例，局部渗液3例，创口皮肤坏死1例，膝关节不稳1例，术后高度丢失4例，创伤性关节炎2例，畸形愈合1例，膝关节僵硬2例。结论术前完整准确诊断能提高手术质量，合适的手术时机和合并症处理和预后密切相关。良好的骨折复位和妥当的内固定及植骨的选择是提高疗效的根本，科学合理的康复计划是手术疗效的保证。

The cause and treatment of the poor prognostic of tibia plateau fracture

Objective To evaluate the effect for the surgical treatment of tibia plateau fracture and to discuss its inefficacious causes. Methods 188 eases of tibia plateau fracture were treated with open reduction and internal fixation from Jan. 2001 to Dec. 2005 in our departments. Factors affecting the clinical results were analyzed. Results 127 eases were followed up 6 months to 5 years and averaged 27.6 months. 17 patients had the operative complications. Poor prognostic rate was 13.38% ; including unsatisfactory reduction of the articular surface in three, wound effusions in three, superficial necrosis in one, the knee instability in one, experiencing height loss after operation in four, traumatic arthritis in two, malunion in one, and the ankylosis of knees in two. Conclusion Integrated and accurate diagnosis before the operation improves the quality of the operation. Appropriate for surgical procedure time is firmly concerned with complications. Nice reduction of fracture and proper choice of internal fixation and bone graft is the key to achieve excellent results. Scientific and reasonable plan of rehabilitation is very important.