胫骨平台骨折的临床治疗探讨

目的：总结胫骨平台骨折的治疗经验。方法：回顾分析2003年4月～2009年3月收治的50例胫骨平台骨折患者的临床资料。结果：50例骨折中,按Schatzker分类：Ⅰ型9例,Ⅱ型18例,Ⅲ型7例,Ⅳ型8例,Ⅴ型5例,Ⅵ型3例,均为闭合性骨折。随访时间为6～12个月（平均10个月）。患膝关节功能评定结果：骨折对位对线良好、膝关节功能完全或基本恢复正常者为优,共30例（占60%）;骨折对位对线较好、内固定使用正确、术后膝关节活动轻度受限、有轻度疼痛或不适,但不影响正常生活者为良,共16例（占32%）;骨折对位对线尚可、关节面不平、内固定使用正确但不可靠、术后膝关节活动受限及疼痛者为一般,共4例（占8%）。结论：胫骨平台骨折对位对线良好,可保守治疗,对关节面塌陷移位〉5 mm的胫骨平台骨折宜采用切开复位内固定术,有骨缺损时需植骨。

Investigation of the tibial plateau fracture treatment

Objective： To Summary the tibial plateau fracture experience.Methods： Retrospective analysis from april 2003 to March 2009 50 cases were treated tibial plateau fracture cases.Results： 50 cases of fracture,according to Schatzker classification： Ⅰ type was 9 cases,Ⅱ type was 18 cases,Ⅲ type was 7 cases,Ⅳtype was 8 cases,Ⅴtype was 5 cases,Ⅵ type 3 cases were closed fractures.Up from 6 to 12 months（mean 10 months）.Suffering from functional evaluation Results： The fracture of the line of good knee function completely or returned to normal as excellent was 30 cases（60%）,fractures of the position of the line better,and internal fixation using the correct knee mild activity limitation,with mild pain or discomfort,but does not affect the normal life are as good was 16 cases（32%）,fractures of the position of the line was acceptable uneven joint surface,fixation using the right but not reliable operation limited after knee and pain in general was 4 cases（8%）.Conclusion： Tibial plateau fracture on a good bit of the line can be treated conservatively collapse of the articular surface displacement 5 mm of the tibia plateau should adopt the open reduction and internal fixation with bone graft when required.