胫骨平台复杂性骨折的手术疗效分析

目的探讨手术治疗复杂性胫骨平台骨折,Schztzker分型IV、V和VI型骨折的疗效。方法收集2003～2006年在本院行切开复位内固定治疗的复杂胫骨平台骨折36例患者资料进行回顾性分析。结果所有病例术后获得10～23个月,平均18个月随访,按Merchant评分标准,优19例,良11例,可4例。优良率83.3%。结论切开复位支撑钢板固定治疗复杂性胫骨平台骨折疗效满意。术前结合螺旋CT检查制定详细手术计划,术中力争解剖复位,足量植骨,坚强固定,术后完备的康复计划是手术成功的关健。

Analysis on surgical treatment of the complex tibial plateau fracture

Objective To investigate the surgical treatment of complex tibial plateau fractures which were typed of IV,V and VI according to Schztzker on tibial plateau fracture. Methods Fom 2003 to 2006,36 cases with complex tibial plateau fractures in our hospital including 10 cases of Schatzker type IV,8 of type V and 18 of type VI were treated with open reduction and internal fixation,of which history information was collected and analyzed retrospectively. Results All cases were followed up from 10 to 23 months,with an average period of 18 months. The knee function was excellent in 19cases,good in 11 cases and fair in 4cases,with the excellent and good rate was 83. 3% according to the Merchant evaluation system. Conclusion In treatment of the complex tibial plateau fracture,open reduction and internal fixation with buttress plates are satisfactory. Examination of spiral CT,preoperative surgical planning to develop detailed,strive intraoperative anatomic reduction,abundant antologous bone graft,a stable internal fixation and a comprehensive rehabilitation are key to the surgical treatment.