胫骨平台骨折的手术治疗策略

目的探讨胫骨平台骨折外科手术治疗的策略和手术方法的选择。方法自2005-06/2009-06共收治胫骨平台骨折98例(陈旧性损伤除外),男62例,女36例,闭合性损伤76例,开放性损伤22例。按Schatzker分类并分别行非手术治疗8例;单髁空心螺钉固定10例;复位植骨单侧支持钢板螺钉固定63例;复位植骨双侧支持钢板螺钉固定17例。结果根据Hohl膝关节功能评分法进行综合评分:优31例,良39例,可20例,差8例。结论根据胫骨平台骨折的特点而选择不同的手术方法,在首先保护骨折部血运的情况下,对胫骨平台进行解剖复位并予以适当的内固定,以及手术后积极的无负重下膝关节功能训练是获得良好手术效果的关键。

Key Points of Surgical Treatment of Tibial Plateau Fracture

Objective To explore the options of the surgical treatment of tibial plateau fracture.Methods From June 2005 to June 2009,98 patients with tibial plateau fracture were treated（old fracture were excluded）,including 76 closed fracture cases and 22 open fracture cases.All the cases were classified by Schatzker standard,and treated respectively by conservative method（8 cases）,unilateral condylar cannulead nail fixation（10 cases）,unilateral internal fixation with sustaining plate and bone implant（63 cases） and internal fixation with doubl sustaining plates and bone implant（17 cases）.Results The outcomes were evaluated according to Hohl knee functional rules.The outcomes were excellent for 31 cases,good for 39 cases,normal for 20 cases and bad for 8 cases.Conclusion The key points to obtain good outcomes of the surgical treatment of tibial plateau fracture are as follow,performing operation according to the characteristics of the tibial plateau fracture,conducting reposition of tibial plateau and internal fixation without the blocking of regional blood supply and the proper physical exercises without weight bearing.