前后联合小切口入路治疗复杂胫骨平台伴后髁骨折临床分析  

Combined anterior-posterior approach for complex tibial plateau and posterior condylar fractures via small incision

作　　者：曾卫平[1] 

机构地区：[1]眉山市人民医院骨科,四川眉山620020

出　　处：《海南医学》2011年第7期11-13,共3页Hainan Medical Journal

摘　　要：目的探讨前后联合小切口入路治疗复杂胫骨平台伴后髁骨折的临床疗效。方法 16例患者术前均经CT扫描及三维重建,全部采用后路和前外侧、后路和前内侧联合入路,后路小钢板和前侧锁定钢板联合固定,同时植骨。结果术后X线片检查示达到解剖复位12例,功能复位4例。1例切口皮缘坏死,经清创后愈合。16例均获12个月以上的随访,骨折全部愈合,愈合时间6.5～9个月,平均7.8个月。Rasmussen评分结果:优7例,良5例,可2例,差2例,优良率为75%。结论胫骨平台骨折三柱分型可帮助医生选择最佳的手术入路和内固定方式,前后联合小切口入路并后路小钢板固定和前侧锁定钢板联合是治疗复杂胫骨平台伴后髁骨折的有效方法。Objective To explore the clinical efficacy of surgical treatment of tibial plateau associated with posterior tibial condylar complex fracture.Methods 16 cases had been used CT scan and three dimensional reconstruction preoperatively,all adopt the posterior and anterior lateral,posterior and anterior combined into the road,medial posterior small steel plate fixed and anterior locking plate joint,and bone graft.Results After operation,X-ray examination reealed 12 cases reach anatomical reattachment,4 cases recover well.1 case the margin of skin Incision is thanatosis,but recovered after debridement.All cases have been followed-up over 12 months,fracture all healed,healing time was 6.5~9 months,7.8 months on average.Among all cases,there were not any screw breakage,steel plate loose,and broken complication,also non-delayed healing.Rasmussen results were excellent in 7 cases,good in 5 cases,fair in 2 cases,poor in 2 cases.Conclusion Combined anterior-posterior with posterior small steel plate fixed and anterior locking plate joint via small incision is an effective treatment to solve complex tibial plateau and posterior condylar fractures.

关 键 词：胫骨平台骨折 联合入路 三柱理论 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]