复杂胫骨平台骨折行解剖钢板内固定术的临床研究

目的观察复杂胫骨平台骨折手术治疗的临床疗效。方法对32例胫骨平台骨折进行分析。骨折按Schatzker分型标准,Ⅳ型16例,V型12例,Ⅵ型4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6～38个月,平均20个月,骨折全部骨性愈合。按HSS膝关节评分标准进行疗效评估,优21例,良8例,可2例,差1例,优良率90.6%。结论解剖钢板内固定术治疗复杂胫骨平台骨折方法可靠,术后并发症较少。骨折的解剖复位、骨缺损处的合理有效植骨、稳定的内固定和早期功能锻炼是减少术后并发症的关键。

Clinical research of the complex tibial plateau fractures fixation with anatomical plate

Objective To explore the surgical treatment effect of the complex tibial plateau fractures.Methods 32 cases tibial plateau fractures were analyzed.According to Schatzker classification criteria,16 cases wereⅣ type,12 cases were V type and 4 cases were Ⅵ type.The patients were fixed with anatomical plate and cancellous bone screws.Results 32 cases were followed up from 6 to 38 months.All fractures healed.According HSS knee score,there were excellent in 21 cases,good in 8 cases and 2 cases and poor in 1 case.The excellent and good rate was 90.6%.Conclusion Anatomical plate fixation of complex tibial plateau fracture method is reliable and less postoperative complications.Anatomical reduction of fractures,bone graft at the rational and efficient,stable internal fixation and early functional exercise can reduce postoperative complications.