三种取骨法在复杂型胫骨平台骨折并骨缺损中的应用  

Clinical application of three bone harvesting methods to treat complicated tibial plateau fractures with bone defects

作　　者：徐云钦[1] 李强[1] 申屠刚[1] 苏佩华[1] 王刚[1] 姚有榕[1] 邓盼[1] 罗正理[1] 魏强强[1] 汤勇[1] 

机构地区：[1]解放军第98医院骨四科,浙江省湖州市313000

出　　处：《中国骨与关节损伤杂志》2012年第10期896-898,共3页Chinese Journal of Bone and Joint Injury

基　　金：南京军区医学科技创新面上A类项目(11MA009)

摘　　要：目的观察3种取骨法在治疗复杂型胫骨平台骨折并骨缺损中应用的疗效。方法68例SchatxkerV、VI型胫骨平台骨折经钢板螺钉内固定同时，术中分别于自体髂骨翼半板取骨（A组，25例）、髂骨翼开窗取骨（B组，23例）和股骨外侧髁开窗取骨（C组，20例）进行植骨。结果均获得12～132个月随访，A、B、C3组手术切口长度：（3．98±0．65）cm、（2．63±0．46）cm、（2.86±O．42）cm；术中出血量：（389．20±97．55）ml、（332．13±74．39）ml、（295．50±68．55）ml；取骨植骨量：（12．15±1．78）cm3、（9．89±1．98）cm3、（12．45±1．97）cm’；取骨并发症发生率：32％、8．7％、5％。结论髂骨翼及股骨外侧髁开窗取骨法较传统髂骨翼半板取骨法具有创伤小、操作简单、并发症少的优点；股骨外侧髁取骨法有利于胫骨平台骨折并骨缺损就近取骨且操作简单；髂骨翼半板取骨法及股骨外侧髁取骨法适用于复杂型胫骨平台骨折合并较大量骨缺损。Objective To study the value of three bone harvesting methods to treat complicated tibial plateau fractures with bone defects. Methods All of 68 patients with complicated tibial plateau fractures with bone defects of Sehatzker V and Vl were divided into three groups randomly. Group A with 25 patients＂ bone was harvested by cutting hemi-bone lamella in ala of ilium. Group B with 23 patients＂ bone was harvested by iliac ala windowing. Group C with 20 patients＂ bone was harvested by external condyle of femur windowing. Results All the patients were followed up for 12-132 months. In group A B and C, the length of the skin incision were （3.98±0.65）cm, （2.63±0.46）em, （2.86±0.42）em respectively, the volume of hemorrhage were （389.20±97.55）ml, （332.13±74.39）ml, （295.50±68.55）ml respectively, the volume of bone harvesting were （ 12.15±1.78）em3, （9.89±1.98）em3, （12.45 ±l.97）em3 respectively. Incision complication rates were 32%, 8.7%, 5%. Conclusion Bone harvested from iliae ala or external condyle of femur by windowing is believed to be a good, lesser trauma, more simple operation, lesser complications. Donor sites in henri-bone lamella in ala of ilium and external condyle of femur could give more than the amount of undergoing ala of ilium windowing. Consequently, we could get enough transplanted bone from them for complicated tibial plateau fractures with bone defeets.

关 键 词：胫骨平台骨折 骨缺损 取骨 并发症 

分 类 号：R683.42[医药卫生—骨科学]