胫骨平台骨折治疗策略及疗效分析

目的探讨胫骨平台骨折临床特点及治疗策略。方法对48例胫骨平台骨折患者，按照不同的Schatzker骨折类型采用松质骨螺钉固定8例，支撑钢板固定40例。结果术后随访1～4年，全部达到骨性愈合，采用rasmussen评分，优良率83．3％。结论CT扫描有助于全面评价胫骨平台骨折。适当的手术时机和胫骨平台骨折关节面的良好复位以及内固定物的正确应用是取得良好治疗效果的关键，患者高龄、合并严重的骨质疏松及过早负重可降低手术的疗效。

Therapeutic strategy and effect analysis of tibial plateau fracture

Objectives The clinical characteristics and therapeutic strategy of tibial plateau fracture was investiga- ted. Methods According to the different Schatzker types of tibial plateau fracture, the 48 patients underwent surgical re- duction and different internal fixations, 8 were spongy bone screw internal fixations and the other 40 were pedestal nickel- clad internal fixations. Results After 1-4 years follow-up, all fractures achieved bony fusion, and acceptance rate reached 83.3% according to Rasmussen scoring. Conclusions CT scanning is helpful in comprehensive evaluation of tibial plateau fracture. The optimal operation time, satisfactory reduction of articular facet, and correct choice of instruments are the keys to good treatment effect. Senility, severe osteoporosis and premature loading may decrease the treatment effect of surgery.