陈旧性胫骨平台骨折治疗体会

目的：探索陈旧性胫骨平台骨折的治疗方法,分析治疗效果。方法：选择8例陈旧性胫骨平台骨折的患者,按Schatzker分型：Ⅱ型2例,Ⅲ型4例,Ⅳ型2例。合并前交叉ⅡI度损伤1例,Ⅱ度损伤1例,内侧副韧带Ⅱ度损伤1例,半月板损伤2例,单纯骨折3例。6例进行手术治疗,2例非手术,根据纪斌平等（1）针对关节炎的评分系统进行疗效评估,内容包括行走、蹲起、活动度、疼痛、肿胀等进行临床评估。结果：手术治疗患者6例,随访18～37个月,非手术患者2例,其中一例得到随访,随访25个月,优良率达85.7%。结论：陈旧性胫骨平台骨折的后期治疗只是对错失一期治疗的补救,近期效果良好,但是远期疗效不佳。有条件者争取早诊断,早治疗。对容易误诊的SchatzkerⅢ型者,早期CT或MRI可明确诊断。

Obsolete shinbone platform bone fracture treatment experience

Goal：Explores the obsolete shinbone platform bone fracture the method of treatment,the analysis treatment result.Method：Chooses 8 example obsolete shinbone platform bone fracture patient,according to Schatzker minute：Ⅱ 2 examples,Ⅲ4 examples,Ⅳ2 examples.Before the merge the overlapping Ⅲdegree damages 1 example,Ⅱ degree damages 1 example,the inside ligamentum accessorium Ⅱ degree damages 1 example,the meniscus damages 2 examples.6 examples carry on the surgery to treat,2 example non-surgeries,equality（1） aim at arthritis according to Ji the Bin the grading system to carry on the curative effect to appraise,the content including walks,squats,the activity,the ache,swelling and so on carries on the clinical appraisal.Finally：The surgery treats the patient 5 examples,makes a follow-up visit for 18-37 month,the non-surgery patient 1 example,makes a follow-up visit for 25 months,fine rate reaches 100%.Conclusion：The obsolete shinbone platform bone fracture later period treatment is only to an error issue of treatment recovery,the effect will be good in the near future,but the forward curative effect will not be good.Some conditions strive for diagnose early,treats early.To Schatzker which easy to misdiagnose Ⅲ,early CT or MRI may be clear about the diagnosis.