胫骨下端关节面穹窿部骨折的分型与治疗  

Classification and treatment of distal tibial plafond fracture

作　　者：李金松[1] 张世华[1] 邵光湘[1] 

机构地区：[1]山东中医学院附属医院

出　　处：《中医正骨》1996年第2期13-15,共3页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：与踝部骨折不同，胫骨下端关节面穹窿部骨折总是造成主要负重关节面的破裂。这种骨折通常是轴向压缩应力与旋转或剪式应力综合作用的结果。作者认为，在考虑诊断时宜将骨折的Ｘ线表现与受伤机理结合起来。通过分析对比各种分型方法，发现由于分型不一，因而难以对各作者的治疗效果进行对比。推荐采用Ｏｖａｄｉａ与Ｂｅａｌｓ分型法，在作治疗计划时宜仔细研究骨折的＂个性＂。一般而言，Ⅰ型骨折非手术治疗即可；Ⅱ型骨折需要切开复位及坚强内固定；除坚强内固定外，Ⅲ型骨折需髂骨植骨；Ⅳ型需扶壁钢板内固定加松质骨植骨；Ⅴ型骨折由于难以通过手术解剖复位，建议采取非手术治疗。Distal tibial plafond fracture, unlike ankle injury, frequently results in rupture of the major weightbearing articular surface. This fracture usually results from the joint effects of axial compression,and rotating or shearing stress.In diagnosis, the X-ray findings and mechanism of the injury should be combined and considered. Through the review and comparison of several methods for classification, the authors found that it is difficult to compare the therapeutic effects of different authors with different classifications, and recommended Ovadia-Realsl's classification. In general, Type I can be satisfactorily treated by non-operative methods; Type Ⅱ should be managed by open reduction and rigid internal fixation; Type Ⅲ requires an iliac grafting besides rigid internal fixation;Type Ⅳ needs a buttress plate fixation as well as cancellous bone grafting; Type Ⅴ should be treated non-operatively because of its difficulty to obtain anatomical reduction by surgery.

关 键 词：胫骨 下端关节 穹窿部骨折 治疗 

分 类 号：R274.12[医药卫生—中医骨伤科学]