胫骨平台骨折合并周围韧带损伤治疗探讨

目的 分析胫骨平台骨折术后随访病例膝关节稳定性的变化，探讨胫骨平台骨折合并周围韧带损伤的发生率及早期诊断和处理措施。方法 对2000年1月～2003年6月期间在我院治疗的不同类型胫骨平台骨折进行回顾，对有随访的57例良好复位的平台骨折病例膝关节稳定度进行分析。结果 随访6个月～2.5年，平均15个月，未见明显膝关节不稳现象，总结出本组病例膝关节稳定性良好的原因：①胫骨平台骨折合并周围韧带损伤发生率低；②胫骨平台骨折合并韧带损伤程度轻；③解剖复位及坚强内固定；④术后良好制动及正确的康复训练指导。结论 胫骨平台骨折合并周围韧带完全断裂的发生率较低，韧带不全损伤非手术治疗可获得良好疗效。

Treatment of tibial plateau fracture associated with ligament injuries

Objective To explore the incidence of tibial plateau fracture with ligament injuries and the early diagnosis and management of the condition. Methods Fifty seven cases of tibial plateau fractures which had been treated operatively from Jan. 2001 to Jun.2003 and had satisfactory reduction of the articular surface were reviewed. The stability of their knee joints was analyzed. Results The follow up lasted 6 to 30 months with an average of 15 months. The incidence of knee unstability was low. The four potential reasons for the postoperative knee stability were found to be: 1) the low prevalence of ligament injury with displaced fractures of tibial plateau; 2) incomplete ligament disruption or mild ligament injury; 3) anatomic reduction and rigid internal fixation; 4) fine and detailed plan for immobilization and functional exercise. Conclusion The prevalence of complete ligament disruption is low, and nonoperative management can result in satisfactory outcomes for tibial plateau fracture with incomplete ligament injury.