截骨复位治疗胫骨外侧平台压缩性骨折  

Osteotomy and reduction for the treatment of lateral tibial plateau compression fractures

作　　者：马台[1] 匡勇[1] 燕晓宇[2] 丁任[1] 包朝鲁[1] 黄健华[1] 孙建忠[1] 

机构地区：[1]上海市宝山中心医院骨科,201900 [2]上海市第六人民医院骨科,201900

出　　处：《中国骨科临床与基础研究杂志》2011年第2期92-96,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨胫骨外侧平台压缩性骨折的治疗方法。方法 2002年1月至2008年12月采用截骨复位、植骨内固定治疗胫骨平台压缩性骨折32例。结果 32例患者获得12～24个月随访,平均随访时间15个月。随访12个月膝关节功能按Rasmussen标准评分,优21例,良9例,可2例,优良率达93.8%。比较术后即刻与随访12个月时胫骨平台塌陷高度、增宽宽度及外倾角,差异无统计学意义(P>0.05)。无螺钉松动、断裂及内固定失败等并发症发生。结论截骨复位法治疗胫骨外侧平台压缩性骨折,具有直视下易于将关节面整复到正常形态和高度、术中形成骨缺损区域小、植骨量少以及易于植入和植实等优点,尤其对于平台边缘有压缩性骨折及伴有胫骨平台增宽的病例,这种手术方法更具实用性。Objective To discuss the treatment of lateral tibial plateau compression fractures. Methods From January 2002 to December 2008, 32 cases of lateral tibial plateau compression fractures were treated using osteotomy, reduction, bone grafting and internal fixation. Results All patients were followed up for 12 to 24 months with the average of 15 months. According to Rasmussen scoring, knee joint function results at 12 months follow-up showed that 21 cases were excellent, 9 cases good, and 2 cases fair. The excellent and good rate was 93.8%. Tibial plateau collapsed height, broadened width and valgus angle at postoperation immediately and 12 months after surgery were compared, and had no significant difference （P 0.05）. No screw loosening, breakage, or fixation failure occurred in these cases. Conclusion Because osteotomy and reduction can easily restore the articular surface to normal appearance and height, create less bone defects, require less bone grafting volume during the operation as well as facilitate simple way to implant bone graft securely, the method is a practical in the treatment of lateral tibial plateau compression fractures, especially for those who have compression fractures at the edge of plateau or some patients accompanied by tibial plateau widening.

关 键 词：胫骨骨折 截骨术 复位 

分 类 号：R687.3[医药卫生—骨科学]