临床治疗胫骨平台后、外髁骨折38例随访分析

目的:探讨胫骨平台后、外髁骨折的外科治疗并进行疗效分析。方法:回顾性分析2004年1月～2007年1月我科收治的38例胫骨平台后、外髁骨折患者,患者平均年龄42.3岁(20～58岁),按AO分型:41-B2型22例,41-B3型11例,41-C5例,所有病例采用后外侧入路钢板复位内固定治疗,术后1、3、6、12、24个月随访患者,行摄片及关节活动度检查,测定胫骨平台内翻角(TPA)及胫骨平台后倾角(PA)。结果:所有病例均获随访,随访时间16～24个月,平均18.4个月。患膝关节功能评定按Hohl评分标准:优28例,良6例,可3例,差1例,优良率89.5%。所有病例无感染、内固定失败情况。结论:膝关节的后外侧入路较前外侧入路能更充分暴露后关节间隙及胫骨平台后、外髁,为骨折的直视复位和植骨内固定提供了良好的操作空间[1]。

Treatment analysis of osteotomy of fibular head to posterolateral tibial plateau fractures:a report of 38 cases

Objective:To study the treatment of posterolateral tibial plateau fractures.Methods:All patients were treated with open reduction and internal fixation through posterior lateral approach.All the patients were followed up at 1 month,3 months,6 months,12 months,24 months postoperatively. Tibial plateau angle(TPA)and posterior slope angle(PA)of tibial plateau were measured to evaluate the stability of proximal tibia and knee alignment.Results:All patients were followed up for 16—24 months with average of 18.4 months.According to Hohl score of the knee joint function,Of these,89.5% had an excellent/good result,7.9% did fair,and 2.6% had a poor outcome.No deep infection or other soft tissue complications were found in this group.Conclusions: The posterior lateral approach can fully expose the posterior joint space and can provide satisfactory operative space for open reduction,grafting and internal fixation[1].