复杂型胫骨平台骨折手术策略及疗效分析

目的 探讨复杂型胫骨平台骨折改良手术入路及双侧双钢板固定临床疗效.方法 2006年3月-2008年12月,收治复杂型胫骨平台骨折21例,其中男14例,女7例;平均年龄37岁.按Schtzker骨折分类:V型10例,Ⅵ型11例.均选择前外侧联合后内侧或后侧入路,双侧双钢板固定,术中探查半月板及交叉韧带损伤,一期修复处理及...

Surgical Strategy and Efficacy Analysis of Complex Tibial Plateau Fractures

Objective To study the clinical efficacy of modified surgical approach and bilateral double-plate fixation in the cases of complex tibial plateau fracture.Methods From March 2006 to December 2008,21 patients with complex tibial plateau fracture,including 14 males and seven females,were treated in our hospital.The average age of them was 37 years old.Based on Schatzker fracture classification,there were 10 cases of type Ⅴ and 11 cases of type Ⅵ fracture.All the cases were treated by the combined anterolateral and posteromedial or posterior approaches and bilateral double-plate fixation.In the operation,we explored injuries on the meniscus and cruciate ligament,and carried out the one-stage rehabilitation and cruciate ligament reconstruction.Results There were 19 cases of one-stage healing,and one case of secondary healing.One patient suffered skin flap necrosis 10 days after the operation,and was cured after changing the medicine.All the patients were followed up for one to three years,averaging at 19.5 months.Bone healing occurred within 5 to 10 months averaging at 7.4 months.Two patients suffered traumatic arthritis;articular surface collapse was found in two patients;and one patient had mild varus knee.According to the scoring system from Hospital for Special Surgery,there were 18 cases of excellent efficacy,two of good efficacy,one of fair efficacy,with an excellence rate of 85.2%.Conclusion Combined anterolateral and posteromedial or posterior approaches and bilateral double-plate fixation for complex tibial plateau fractures is beneficial to protect the soft tissue blood supply and give reliable fixation stability.Thus,it is a feasible and effective method and is worth further research and popularizing in clinical practices.