复杂胫骨平台骨折的手术治疗

目的 探讨复杂性胫骨平台骨折的手术治疗方法和疗效.方法 复杂性胫骨平台骨折62例,均经切开复位,螺丝钉、钢板内固定,骨缺损者同时给予植骨.结果 随访5～24个月,所有患者伤口均I期愈合,无皮肤坏死、下肢深静脉栓塞等并发症发生.X线显示无骨折畸形愈合,均恢复患肢正常力线,无内固定松动.按Sanders膝关节评分法优21例,良33例,可8例,优良率达87.10%.结论 复杂性胫骨平台骨折应考虑手术治疗,选择合适的手术时机和手术切口、骨折解剖复位、植骨和坚强内固定,以及术后正确的康复锻炼是提高复杂性胫骨平台骨折疗效的重要因素.

Study on surgical treatment of complex tibial plateau fractures

Objective To explore the method and effect of treatment for complex tibial plateau fractures. Methods Sixty two cases of complex tibial plateau fractures were treated by open reduction, screw fixation and bone defect with bone plantation. Results All patients were in stage I wound healing without skin necrosis, deep vein thrombosis and other complications after follow - up for 5 to 24 months. X - ray re - examination showed no malunion of fractures, and fractured limbs were restored to normal power line, without loosening of internal fixation. According to Sanders knee scores： excellence was seen in 21 cases, good in 33 cases, effective in 8 cases, and good and excellent rate reached 87.10%. Conclusion Surgical treatment should be considered in complex tibial plateau fractures, it is important to select appropriate time for surgery, surgical incision, anatomical reduction, bone grafting and internal fixation, and postoperative rehabilitation exercises are also important factors for improving the effectiveness of treatment for complex tibial plateau fractures.