手术治疗累及后髁的复杂性胫骨平台骨折  

Surgical Treatment of Complex Tibial Plateau Fracture Involved with Poster Condyle

作　　者：陈志伟[1] 刘春磊[1] 罗俊标[1] 杨乐忠[1] 

机构地区：[1]南华大学第一附属医院骨科,湖南衡阳421001

出　　处：《实用骨科杂志》2011年第5期402-403,407,共3页Journal of Practical Orthopaedics

摘　　要：目的观察联合不同手术入路,切开复位内固定治疗累及后髁的复杂性胫骨平台骨折的临床疗效。方法 2005年10月至2009年6月,对23例累及后髁的复杂性胫骨平台骨折行切开复位内固定。于术后1、2、3、6、9、12个月复查,分别进行临床查体、X线评估及康复指导。骨折愈合后对患者膝关节功能以Lysho lm评分系统评分。结果全部病例获完整随访,平均随访25.6个月(15个月～5年)。骨折全部愈合,愈合后下肢全长X线显示下肢力线无成角及旋转,Lysho lm膝关节功能评分:术前0～54分,平均(23.45±5.23)分;术后76～93分,平均(84.34±7.53)分。根据M o lster对Lysho lm评分的分级方法进行评价,本组优12例,良7例,可2例,1例伤口感染,1例发生创伤性骨关节炎,无骨筋膜室综合征等其他严重并发症,优良率82.5%。结论联合不同手术入路,充分暴露胫骨平台后髁骨折,对其进行解剖复位、坚强内固定可取得较好临床疗效。Objective To observe the clinical effect of the treatment of complex tibial plateau fracture involved with poster condyle through combined different approaches.Methods 23 cases with complex tibial plateau fractures involved with poster condyle were treated with open reduction and internal fixation through combined different approaches from October 2005 to June 2009.Interviews were taken in 1st,2nd,3rd,6th,9th,12th months after operations,and the physical examinations,X-ray evaluations,rehabilitation instructions were performed.The evaluation of keen function was taken with Lysholm score system after fracture healing.Results All the cases were followed-up with mean time 25.6 months（15 months～5 years）.No case of ununion,no malalignment,rotation was observed according to Lysholm score.The preoperative Lysholm scores ranged from 0 to 54,with a mean of（23.45±5.23）,and the postoperative Lysholm scores ranged from 76 to 93,with a mean of（84.34 ±7.53）.12 cases were excellent,7 good and 2 fair,1 case of infection,1 case of traumatic osteoarthritis,without a compartment syndrome and no other serious complications,the excellent and good rate was 82.5%.Conclusion It is an effiective method in the treatment of he complex tibial plateau fracture involved with poster condyle through combined different approaches which provide sufficient exposure combined with anatomical reduction and rigid internal fixation.

关 键 词：胫骨平台 骨折 内固定 手术治疗 

分 类 号：R683.42[医药卫生—骨科学]