胫骨平台解剖型后侧锁定钢板内固定治疗胫骨平台后侧骨折

目的探讨胫骨平台解剖型后侧锁定钢板内固定治疗胫骨平台后侧骨折的临床疗效。方法回顾性分析自2012-04—2013-07采用胫骨平台解剖型后侧锁定钢板内固定治疗的46例胫骨平台后侧骨折。记录手术时间、术中出血量、住院时间、骨折愈合时间。测量术后即刻和术后1年患肢胫骨平台内翻角（TPA）、后倾角（PA）及胫股角（FTA）。末次随访时膝关节功能评估采用美国特种外科医院（HSS）膝关节功能评分系统评定。结果本组手术时间（59.0±14.2）min,术中出血量（96.0±16.7）ml,住院时间（13.6±4.5）d。所有患者均获得随访（16.8±4.2）个月,骨折愈合时间（13.6±2.8）周。末次随访时膝关节功能HSS评分为（89.7±5.6）分,优良率93.5%。术后即刻与术后1年的患肢TPA、PA及FTA的比较差异无统计学意义（P〉0.05）。结论胫骨平台后侧锁定钢板内固定治疗胫骨平台后侧骨折具有内固定放置方便、手术时间短、出血量少、膝关节功能恢复好等优点。

Operative treatment of posterior tibial plateau fractures with posterior tibial plateau anatomic locking plate

Objective To evaluate surgical outcomes of posterior tibial plateau anatomic locking plate for treatment of poste- rior fibial plateau fractures. Methods Forty six patients with posterior tibial plateau fractures treated by posterior tibial plateau anatomic locking plate from April 2012 through July 2013 were retrospectively analyzed. The operation time, intraop- erative blood loss, hospital stay and the fracture healing time were collected, and the tibial plateau angle, posterior slope angle and femorotibial angle in immediately postoperatively and at one year after operation were measured, and the knee functional were evaluated by the Hospital for Special Surgery knee score. Results In this cohort the mean operation time was （59.0±14.2）min, intraoperative blood loss was （96.0±16.7）ml and hospital stay was （13.6±4.5）days. All patients were followed up for an average of （16.8±4.2）months, and the fracture healing time was （13.6±2.8）weeks. According to the Hospital for Spe- cial Surgery Score, the averaged score was （89.7±5.6）points, with good and excellent rate of 93.5%. There was no statistic sig- nificant difference in the average tibial plateau angle, posterior slope angle and femorotibial angle between immediately after operation and those at one year after operation （P 〉0.05）. Conclusion Internal fixation with posterior tibial plateau anatomic locking plate is agood method for treatment of posterior tibial plateau fractures with easier location, shorter operation time, less invasion and the excellent clinical results.