复杂胫骨平台骨折治疗探讨

目的探讨复杂胫骨平台骨折治疗方法及临床疗效。方法回顾性分析2007年3月～2012年3月本院63例复杂胫骨平台骨折患者资料,术前行胫骨平台CT平扫及三维重建,根据CT结果行相关切口入路复位、植骨内固定,术后参照Rasmussen临床评分标准评估膝关节功能。结果本组患者获得7～16个月随访,平均8.3个月,全部骨折愈合,患者膝关节功能：优30例,良25例,可3例,差5例,优良率为87.3%。结论根据胫骨平台CT提示行相关切口入路复位、植骨、内固定治疗复杂胫骨平台骨折的效果较好,术后适当进行功能康复锻炼,并发症少,可有效改善患者生活质量。

Discussion on the treatment of complex tibial plateau fractures

Objective To explore the therapeutic method and clinical effect of complex tibial plateau fractures. Meth- ods 63 cases of patients with complex tibial plateau fractures from March 2007 to March 2012 were retrospectively analyzed. The CT scan on tibital plateau and three-dimensional reconstruction were performed before surgery. The ap- proach and reduction of related incisions, bone grafting with internal fixation were implemented based on indications of CT scan. The function of knee joint was evaluated by reference to clinical scoring standard of Rasmussen after surgery. Results All patients were followed up for 7 to 16 months, with an average of 8.3 months. The bones in all cases were healed. The function of the knee joint was evaluated according to Rasmussen criteria, the outcomes were excellent in 30 cases, good in 25 cases, fair in 3 cases, and poor in 5 cases, excellent and good rate was 87.3%. Conclusion In the treatment of complex tibial plateau fractures, operations of approach and reduction of related incisions, bone and internal fixation based on CT scan can obtain favorable effects. The appropriate functional rehabilitation can reduce complications and improve patient＇s quality of life. grafting, exercise