胫骨平台骨折非解剖复位对膝关节功能影响的研究  

Impact of articular unanatomic reduction on joint function in tibial plateau fractures

作　　者：汤旭日[1] 王秋根[1] 纪方[1] 张秋林[1] 沈洪兴[1] 汪滋民[1] 唐昊[1] 陆晴友[1] 王万宗[1] 吴剑宏[1] 汪方[1] 杜明奎[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海市200433

出　　处：《中华创伤骨科杂志》2005年第3期210-213,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的分析随访病例关节移位的类型、部位、程度对膝关节功能的影响,探讨影响胫骨平台骨折治疗效果的关键因素。方法对1991年6月～2004年6月间在我院治疗的不同类型胫骨平台骨折进行回顾性分析,对有良好随访的29例未达解剖复位或术后出现复位丢失的病例的X线片进行分析,并进行膝关节功能评分。结果随访6个月～13年,平均3.5年,膝关节功能参照Rasmussen评分法,优11例,良13例,可4例,差1例,优良率达82.75%。结论胫骨平台骨折获得良好治疗效果首先要恢复膝关节的稳定性,其次要恢复膝关节良好的力线,再者要在保护膝关节周围软组织情况下恢复关节面的解剖复位,并要有完善、合理的康复计划。AbstractObjective To analyze the impact of intraarticular stepoff on knee functions in the tibial plateau fracture and to determine significant factors that can affect the treatment. Methods Patients with tibial plateau fracture who had been treated in our department from June 1991 to June 2004 were retrospectively reviewed. Followups found that 29 cases experienced unanatomic reduction of the articular surface. Their radiograms were analyzed. Results The followup lasted 6 months to 13 years (average 3.5 years). The excellent and good rate was 82.75%in Rasmussen grading system. Conclusion The key points to achieve excellent results are stability of the knee restored, malalignment rectified, anatomic reduction on the condition of protecting soft tissue and an appropriate plan for early functional exercise.

关 键 词：胫骨平台 骨折 治疗 非解剖复位 膝关节功能一1…一 一 r.…一一一' ■.…一’ 

分 类 号：R683.42[医药卫生—骨科学]