复杂胫骨平台骨折的手术治疗

目的探讨复杂胫骨平台骨折内固定治疗的临床效果，方法回顾性总结手术治疗复杂胫骨平台骨折68例，根据骨折类型采用“T”型，“L”型支持钢板，双钢板，解剖钢板，锁定钢板和胫骨近端微创内固定系统作内固定。骨折塌陷部位复位后的骨缺损应用髂骨或人工骨植骨39例。同时分析伤后手术时机，术后膝关节功能锻炼对膝关节功能的影响。结果68例中52例获得随访，采用Rasmussen评分标准评定临床疗效，优：42例（67％），良：12例（19％），可：6例（10％），差：2例（4％）。优良率86％。结论复杂结果平台骨折手术治疗需依据骨折类型，遵循分期治疗、早锻炼、晚负重原则。

Surgical treatment of the complicated fractures of the tibial plateau

Objective To investigate the therapeutic effect of the complicated fracture of tibial plateau treated by open reduction and internal fixation. Methods Surgical treatment in 68 cases with complicated fractures of the tibial plateau were analyzed retrospectively, T type plate, L type buttress plate, double plates, anatomical plate,locking plate and less invasive stabization system were adopted for different fractures,iliac or artificial bone grafted in the reconstruction of bone defect after the depression replaced. The time of operation and the effect of functional exercise in the postoperative patients to recover the function of the knees were analyzed at the same time. Results 52 patients of 68 cases were followed-up. Based on Rasmussen rating system,the recovery of knee joint function were excellent in 42cases(67%) ,good in 12 cases(19%) ,fair in 6 cases(10%) and poor in 2 cases(4%) ,the excellent-and-good rate was 86%. Conclusion Surgical treatment of the complicated fractures of the tibial plateau depended on the kind of fracture, therapeutic principles by stages. Moreover, bone grafte after the depression replaced in bone defect was neeassary,good internal fixtion oould meet functional exercise,soft tissue injuries like ligament and meniscus should be well treated,follow the principles of early exercise and delay weightbearing.