Lobenhoffer入路治疗MooreⅠ型胫骨平台后内侧劈裂骨折  

Management of Moore typeⅠposteromedial split fracture using Lobenhoffer approach

作　　者：冯华明[1] 易成腊[2] 宋先舟[2] 胡耑[2] 赵鸿[2] 李占飞[2] 郑国寿[2] 白祥军[2] 

机构地区：[1]孝感市中心医院骨科,湖北孝感432100 [2]华中科技大学同济医学院附属同济医院创伤外科,湖北武汉430030

出　　处：《创伤外科杂志》2011年第5期413-415,共3页Journal of Traumatic Surgery

摘　　要：目的探讨后内侧Lobenhoffer入路治疗MooreⅠ型胫骨平台后内侧劈裂骨折的手术方法和效果。方法采用Lobenhoffer入路治疗MooreⅠ型胫骨平台后内侧劈裂骨折6例。自腘横线沿腓肠肌内侧头直切口,沿半腱肌和腓肠肌内侧头间隙暴露骨折端,骨折块直视下复位,后方放置支撑钢板固定。采用De-Coster评定标准评定骨折复位情况和纽约外科专科医院膝关节功能评分(HSS)法行膝关节功能评定。结果 6例经过13～24个月(平均14.8个月)随访,6例全部愈合,平均愈合时间(X线检查)为13.7周;术后X线片检查达到解剖复位5例,复位良好1例;膝关节功能HSS评分为86～97分,平均90.3分。无血管损伤、伤口感染和皮缘坏死等并发症。结论 Lobenhoffer入路能充分暴露胫骨后内侧平台,较少软组织剥离和直视下对后内侧劈裂骨折复位固定,是治疗MooreⅠ型胫骨平台骨折理想入路。Objective To describe the operative procedures and clinical outcomes of Moore type I postero-medial split fracture using Lobenhoffer approach.Methods Six patients with Moore type I tibial plateau fracture were operatively treated utilizing Lobenhoffer approach.The skin incision was performed straight along the border of the medial head of gastrocnemius at the level of the medial joint line.The fracture was exposed between the interval of the semitendinous muscle and the medial gastrocnemius head.The fragments were reestablished directly and fixed using posterior buttress plate.Reductions were assessed according to the methods of DeCoster and the functional outcomes were assessed by HSS knee outcome score respectively.Results All patients were followed up with an average period of 14.8 months（ranging from 13 to 24 months）.All fractures got healed with an average healing time of 13.7 weeks.Anatomic（5 patients） and good（1 patient） reduction was achieved in these 6 patients.The average HSS knee score was 90.3（86-97）.No vascular injuries,infections and skin necrosis were found postoperatively.Conclusion Lobenhoffer approach with posterior buttress plate is a good clinical method for treating Moore type I posteromedial split fracture,with the advantages of allowing excellent fracture visualization,appropriate placement of hardware and minimal soft tissue dissection.

关 键 词：胫骨骨折 手术 

分 类 号：R683.42[医药卫生—骨科学]