治疗胫骨平台后侧骨折18例分析与体会  

Experience in treating 18 cases of posterior tibial plateau fractures

作　　者：李鑫[1] 刘谟震[1] 汤欣[1] 吕德成[1] 

机构地区：[1]大连医科大学附属第一医院骨科,116011

出　　处：《中国骨肿瘤骨病》2011年第5期490-493,共4页Chinse Journal Of Bone Tumor And Bone Disease

基　　金：辽宁省科技厅科研项目(2009A197);辽宁省自然科学基金项目(20092167)

摘　　要：目的探讨胫骨平台后侧骨折治疗的入路及临床疗效。方法回顾分析本院2007年5月至2010年5月收治的有完整资料且获得随访的18例胫骨平台后侧骨折手术患者。骨折类型按Schatzker分型:Ⅱ型8例,Ⅲ型3例,Ⅳ型4例,Ⅴ型2例,Ⅵ型1例。采用后方倒"L"型或后方倒"L"型联合内侧/前外侧切开复位,恢复关节面平整,原平台塌陷下方植入髂骨或人工骨,钢板、螺钉内固定。结果随访8～32个月,平均(19.63±2.25)个月,采用Rasmussen评价标准,优良12例,可2例,差4例,优良率66.6%。结论采用后方倒"L"型或后方倒"L"型联合内侧/前外侧切开复位内固定加植骨治疗复杂胫骨平台后方骨折,效果良好。Objective To evaluate the approach and efficacy of the posterior tibial plateau fractures. Methods 18 cases with complete data and being followed vp underwent surgical treatments for their posterior tibial plateau fractures from May 2007 to May 2010, they were retrospectively analyzed. According to standard of Schatzker, type Ⅱ were in 8, type Ⅲin 3, type Ⅳin 4, type Ⅴ in 2, and type Ⅵ in 1. All cases were treated through inverted or L-shaped rear combined with medial/antero-lateral open reduction, rectoring the articular surface flat bone graft and Internalfixation in the collapsing lower part of original platform by lilac/bone, plates and screws. Results All patients were followed up from 8 to 32 months, with an average of 19.63±2.25 months. According to Rasmussen standard 12 patients obtained excellent and good result, 2 fair and 4 poor, with their good-excellent rate was 66.6%. Conclusions we can achieve satisfactory clinical outcome through inverted L-shaped rear or inverted L-shaped rear combined with medical/ anterolateral open reduction and internal-fixation and bonegraft in treating the posterior tibial plateau fractures.

关 键 词：胫骨平台骨折 切开复位 钢板 

分 类 号：R687.3[医药卫生—骨科学]