切开复位钢板内固定并植骨治疗复杂型胫骨平台骨折

目的总结复杂型胫骨平台骨折的手术治疗经验。方法治疗复杂型胫骨平台骨折38例,行切开复位,钢板内固定术,骨缺损病例同时行植骨术。结果 33例获得12～24个月随访,平均18个月,全部病例均在4个月内骨折愈合,无深部感染及内固定失败。按Sanders膝关节评分法评定结果为优15例,良12例,可6例,总优良率81.8%。结论复杂型胫骨平台骨折手术治疗应根据骨折类型选择不同的手术方法,充分植骨能恢复关节面的平整,同时应注意患肢解剖力线的恢复,此二者是获得术后良好膝关节功能的关键。

Surgical treatments of complex tibia plateau fractures with plate fixation and bone grafting

Objective To summarize surgical treatment experiences of complex tibia plateau fractures.Methods 38 cases of complex tibia plateau fractures were treated with open reduction and plate fixation,bone grafting was applied in bone defect cases.Results 33 patients get 12 to 24 months follow-up,at an average of 18 months,fracture healing was achieved in all patients in four months,no deep infection or loss of fixation.According to Sanders’ treatment result classification of open knee joint injuries,15 cases were classified as optimal,12 cases were classified as good,6 cases were classified as ordinary,with a good rate of 81.8%.Conclusion Treatments of complex tibia plateau fractures could apply different surgical methods according to fracture types.Applying of bone grafting can ensure the smoothness of the articular surface,and recovery of normal force line of the trouble limb should also be pay attention to.Both of them are keys for good joint function after operation.