关节镜辅助下内外联合双钢板内固定治疗复杂胫骨平台骨折  

Arthroscopic-assisted Bilateral Approach and Bi-plate Fixation for Complicated Tibial Plateau Fractures

作　　者：赵刚[1] 赵延胜[1] 崔红林[1] 

机构地区：[1]安徽省阜阳市人民医院脊柱及创伤病区,阜阳236000

出　　处：《中国现代手术学杂志》2011年第1期42-44,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨关节镜辅助下内外侧联合入路双钢板内固定治疗复杂胫骨平台骨折的临床效果。方法复杂胫骨平台骨折42例,其中SchatzkerⅣ型3例,Ⅴ型27例,Ⅵ型12例,均采用内外联合入路,关节镜协助操作及检查关节面的复位情况,同时治疗半月板损伤14例及交叉韧带损伤13例。充分植骨以支持关节面的复位。内固定方法:内侧采用小T型或重建锁定钢板,外侧采用加压或锁定高尔夫型钢板。结果 41例伤口一期愈合,1例切口皮肤软组织坏死行皮瓣修复后愈合。本组42例经平均2.6(0.5～4)年随访,骨折愈合时间平均5(3～19)个月。按Lysholm膝关节功能评分标准,优35例,良4例,中3例,优良率92.9%。所有病例无膝关节内外翻畸形,仅有3例(7.1%)术后有轻度的关节面再次塌陷。结论关节镜辅助下内外双侧钢板内固定治疗复杂胫骨平台骨折是简单有效的办法,内固定稳定,术后可进行早期功能锻炼,疗效确切,并发症少。Objective To evaluate the role of arthroscopic-assisted internal and external double plates fixation for the complex tibial plateau fractures.Methods 42 patients of complex tibial plateau fractures,including 3 of Schatzker＇s Ⅳ,27 of Schatzker＇s Ⅴ and 12 of Schatzker＇s Ⅵ were treated by the arthroscopic-assisted internal and external double plates fixation.14 cases of meniscus injury and 13 cases of cruciate ligament injury were repaired simultaneously.Results All the cases cured except one case had flap repaired because of wound necrosis.In the 42 cases who were followed up for 2.6（0.5～4） years,the fracture healing time was 5（3～19） months.According to the Lysholm evaluation criterion,there were 35 cases of fine,4 cases of good and 3 cases of common.3 cases（7.1%） suffered from the mild collapse of the articular surface,but no bowleg or evaginate deformity happened.Conclusion Arthroscopic-aided bilateral plate fixation is a simple and effective method for the complicated tibial plateau fracture with advantages of stable internal fixation,early postoperative functional exercise,definite effect and little complications.

关 键 词：胫骨骨折 骨折固定术 关节镜检查 

分 类 号：R687.3[医药卫生—骨科学]