胫骨平台骨折的现代治疗

现代胫骨平台骨折的治疗方向是有限切开、直接或间接复位、生物学固定。治疗方法包括关节镜辅助手术、经皮螺钉接骨板微创固定、环状和组合式外固定器应用、临时跨越式外固定支架固定、内固定与外固定器的联合使用或上述方法分期进行治疗。注重骨折治疗的同时，也注意关节韧带、半月板等组织的保护和治疗。对于开放性高能量双髁骨折可分期治疗，强调早期的关节面恢复，重点保护软组织，可行肌皮瓣移位修复保护创面，植骨可在二期进行。微创内固定系统(LISS)是治疗胫骨平台骨折的一项新技术。

Modern treatment of tibial plateau fracture

The mainstream of modern treatment of tibial plateau fracture is limited opening, direct or indirect reduction, and biological osteosynthesis. The treatment methods include arthroscopy assisted operative management, minimally invasive internal fixation with percutaneous screws and plates, application of circular and combined external fixators, temporary fixation with longer external fixators, combined application of internal and external fixators and two stage operations with the above mentioned methods. Surgeons should take care not only of the treatment of fracture, but also of the protection and therapy of injured articular ligament, meniscus and other tissues. The open high energy bicondylar fractures of tibia can be treated by two stage therapy. At the early stage of the therapy, restoration of articular surface and protection of soft tissues are the key points. The wounds can be repaired by musculocutaneous flaps, and the bone defects can be repaired by bone graft at the second stage. Less invasive stabilization system (LISS) is a new technique to treat the tibial plateau fracture.