开窗植骨钢板内固定治疗胫骨平台塌陷骨折远期随访

目的研究开窗植骨钢板内固定术治疗胫骨平台塌陷性骨折10年以上的远期疗效。方法 1997年9月—2001年1月,采用开窗植骨钢板内固定术治疗胫骨平台塌陷性骨折101例,分析膝关节的Kellgren-Lawrence X线分级和Lysholm膝关节功能评分,研究骨折Schatzker分型、性别、年龄和植骨方式对关节功能的影响。结果 Schatzker分型越高,KellgrenLawrence X线级别分布越高(P<0.01),膝关节的Lysholm功能评分越低(P<0.01);男、女两组间Kellgren-Lawrence X线分级差异无统计学意义(P>0.05),但男性组的lysholm膝关节功能评分高于女性组(P<0.01);年龄越高,Kellgren-Lawrence X线级别分布越高(P<0.01),膝关节的Lysholm功能评分越低(P<0.01);自体髂骨植骨与同种异体骨植骨两组间Kellgren-Lawrence X线分级和lysholm膝关节功能评分均无统计学意义(P>0.05)。结论开窗植骨钢板内固定术治疗胫骨平台塌陷性骨折,可获得满意的远期疗效,骨折的Schatzker分型、性别、年龄是影响膝关节远期功能的主要因素,骨移植方式对膝关节功能无明显影响。

Long-term results of tibial plateau fractures treated with bone graft and internal fixation

Objective To evaluate the long-term results of tibial plateau fractures treated with bone graft and internal fixation for over 10 years. Methods From September 1997 to January 2001, 101 patients with tibial plateau fracture with depressed articular surfhce were treated with bone graft and internal fixation. We evaluate knee function across Kellgren ＆ Lawrence X-ray grade, knee Lyshohn function scores, sex, age and method of bone graft. Results The Kellgren ＆ Lawrence X-ray grade and knee Lysholm function scores were improved in high Schatzker group and low age group （ P 〈 0.01 ）. There were no differences between male and female groups according to Kellgren ＆ Lawrence X-ray grade （ P 〉 0.05 ） , but Lysholm function scores in male group were higher than that in female group （P 〈 0.01 ）. There were no differences according to Kellgren ＆ Lawrence X-ray grade and Lysholm function scores in autogenous bone graft group and allogeneic bone graft group （ P 〉 0.05 ）. Conclusion Treatment of tibial plateau fractures with bone graft and internal fixation is of satisfactory long-term effect, Schatzker classification, sex and age are the important factors, and autogenous or allogeneic bone graft does not influence the knee function.