双钢板治疗复杂性胫骨平台骨折的效果观察

目的探讨双钢板治疗复杂性胫骨平台骨折的效果。方法2009年4月－2013年10月本院对15例SchatzkeⅤ型、12例Schatzke Ⅵ复杂性胫骨平台骨折患者采用双钢板治疗，采用内、外侧2个切口，术中注意皮瓣长宽比例及剥离面，内侧用T或L型板、外侧用高尔夫球板固定。结果术后所有患者均获得随访，时间为5～24个月，其中1例皮瓣坏死，采用旋转皮瓣修复覆盖创面，所有患者均良好愈合，根据Rasmussen评分标准评定膝关节功能：优20例、良4例、中3例。结论采用双钢板治疗复杂性胫骨平台骨折可以降低胫前皮瓣坏死率，更少破坏骨折端血供，具有固定可靠、术中损伤小等特点，术后早期恢复快，关节功能满意。

Effect observation of double plates in the treatment of complex tibial plateau fractures

Objective To explore the effect of double plates in the treatment of complex tibial plateau fractures. Methotis From April 2009 to October 2015,patients with complex tibial plateau fractures in schatzke V type （n=15） and schatzke VI type （n=12） were treated by double plates with internal and external incisions.During surgery,length-to- width ratio of flap and stripped surface should be paid attention.For fixation,T or L-shaped plate was selected for internal side,while golf clubs bone plate was chosen in external side. Results All patients after surgeries were followed up, and the period ranged from 5 to 24 months.One case occurred with skin flap necrosis,and was successfully cured after rotation flap repairing in order to cover wound surface.According to Rasmussen scoring standard on evaluating functions of knee joint,excellence was in 20 cases,goodness in 4 cases,and medium in 3 cases. Conclusion Application of double plates in the treatment of complex tibial plateau fractures can reduce the necrosis rate of pretibial flap and avoid damaging blood supply in fracture end at advantages of stable fixation,mild damage during surgery,fast recovery at early period of postoperation,and satisfaction on joint function.