胫骨平台骨折术后临床与影像的比较研究  

A Comparison of Functional and Roentgenographic Results after ORIF of Tibial Plateau Fractures

作　　者：张怀华[1] 孙永青[1] 沈慧良[2] 

机构地区：[1]华北电网有限公司北京电力医院骨科,北京100073 [2]首都医科大学附属宣武医院,北京100053

出　　处：《实用骨科杂志》2009年第7期507-509,共3页Journal of Practical Orthopaedics

摘　　要：目的通过对胫骨平台骨折术后病例资料的随访,比较术后膝关节功能与影像表现间的关系。方法对2001年～2007年的31例胫骨平台骨折手术患者进行回顾性分析,平均随访时间（37±3）个月。采用膝关节外科协会（the hospital for special surgery,HSS）评分系统评价膝关节功能;Rasmussen胫骨髁部骨折复位解剖学评分和Reswick-Niwayama评分分别评价骨折术后早期和随访时关节退变的影像表现;统计学采用“诊断试验的一致性检验”分别比较Rassmussen评分、Reswick-Niwayama评分与HSS评分之间的一致性;两变量间的相关性分析比较Rassmussen评分与Reswick-Niwayama评分的相关性,数据经SPSS11.5软件处理。结果Rassmussen评分：优7例,良14例,可10例;Reswick-Niwayama评分：0级6例,1级9例,2级16例;HSS评分：优16例,良13例,中2例。Rassmussen评分、Reswick-Niwayama评分与HSS评分之间的一致性差;Rassmussen评分与Reswick-Niwayama评分之间的相关性有显著统计学差异（P〈0.05）。结论在影像表现上,胫骨平台骨折术后早期表现与随访时关节退变程度之间有相关性,但骨折术后影像表现不能完全反映术后膝关节功能状态。Objective To compare the knee clinical function after the open reduction and internal fixation with the roentgenographic examination by followed up the tibial plateau fracture cases. Methods Thirty-one tibial plateau fractures from 2001 to 2007 had been retrospectively analyzed,the average time were 37±3 months. The Hospital for Special Surgery（HSS） knee-rating score are used to assess the patient clinical function. The Rasmussen＇s anatomical grading system at the postoperatively and the Reswiek Niwayama criteria on the degenerative grading scale at the late stage are used respectively. The statistics method：we use the consistency examination of the diagnosis test to compare with the consistency about the Rasmusse＇s anatomical grading system,Reswiek-Niwayama and The Hospital for Special Surgery knee-rating score criteria differently,and analyze the relativity about the Rassmussen score and Reswick- Niwayama score with the two variable relativity analysis ,the spss 11. 5 software deal with the data. Results Based on the Rasmussen＇s anatomical grading system,seven of them had excellent result ,fourteen were good,ten were fair,no poor cases. The Reswick-Niwayama criteria,six were 0 grade,one were 1 grade,sixteen were 2 grade,no one were 3 grade. The Hospital for Special Surgery knee-rating score, 16 were excellent, 13 were good, 2 were fair,0 were poor. The statistics results show that there are no statistics significance between the Rasmussen＇s anatomical grading, Reswick-Niwayama score and the Hospital for Special Surgery knee-rating score. There are statistic significance between the Rasmussen＇s anatomical grading and Reswich-Niwayama score（P〈0.05）. Conclusion There are relativity between the Rasmussen＇s anatomical grading and Reswick-Niwayama score,but the radiological representation about the reduction＇ of the tibial plateau fracture and the degenerative grading scale can＇t represent the knee clinical function well.

关 键 词：胫骨平台骨折 影像学 临床功能 

分 类 号：R683.42[医药卫生—骨科学]