胫骨平台骨折33例手术治疗分析

目的:探讨胫骨平台骨折的手术治疗的临床疗效。方法:对2005年6月到2009年12月间我科收治的胫骨平台骨折33例进行分析。骨折按Schatzker分型标准,Ⅰ型4例,Ⅱ型12例,Ⅲ型9例,Ⅳ型4例,Ⅴ型3例,Ⅵ型1例均采用解剖型钢板,松质骨螺钉固定,骨缺损者给予人工骨或自体髂骨植骨。结果:30例获得随访,随访时间年6~18月,平均14月,骨折全部骨性愈合。按采用Sanders膝关节评分法评估疗效,优23例,良7例,可2例,差1例。优良率91%。结论:手术是治疗胫骨平台骨折的有效方法,手术方法根据骨折的不同类型而异,术后并发症的发生与骨折的严重程度密切相关。解剖复位、骨缺损植骨、稳定的固定和早期功能锻炼是减少并发症的关键。

Surgical treatment of tibial plateau fracture:33 cases report

Objective: To investigate effect of the surgical methods on the tibial plateau fracture.Methods: 33 cases of tibial plateau fractures were analyzed from June 2005 to December 2009.According to Schatzker classification standards,there wereⅠtype 4 cases,Ⅱtype 12 cases,Ⅲtype 9 cases,Ⅳ 4 cases,Ⅴ type 3 cases,Ⅵ type 1 cases.All of them were used anatomical plate and cancellous bone screws.Bone defects were given autogenous iliac bone or graft.Results: 30 patients were followed up for 6-18 months(average 14 months),and all fractures healed.Knee score according to evaluation by Sanders efficacy was excellent in 23 cases,good in 7 cases,normal 2 cases and poor in 1 case.Excellent rate was 91%.Conclusion: Surgery is the treatment of tibial plateau fracture and effective method.Surgical methods were decidet by the different types of fracture varied.Surgical complications were correlated with the severity of fracture.Anatomical reduction,bone grafting,stable fixation and early exercise is the key to reduce complications.