胫骨平台后柱骨折的治疗(附16例报告)  

Treatment of posterior column tibial plateau fractures:a report of 16 cases

作　　者：冯国滨[1] 弋石泉[1] 杨帆[1] 邹宏[1] 沈建平[1] 殷勇[1] 王辉[1] 谢成[1] 

机构地区：[1]四川省绵阳市骨科医院关节创伤外科,621000

出　　处：《中国骨与关节杂志》2012年第6期603-605,638,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨后侧入路钢板内固定治疗胫骨平台后柱骨折的手术方法和临床疗效。方法 2008年1月至2011年9月经后侧入路钢板内固定治疗单纯胫骨平台后柱骨折的16例患者,有11例接受后内侧入路手术,有5例接受后外侧入路手术,其中男12例,女4例,年龄23～45岁,平均31.5岁。结果 16例患者获得6-31个月(平均18个月)随访,骨折均骨性愈合,愈合时间3-6个月(平均3.8个月),未出现内固定钢板螺钉断裂、松动、弯曲及骨折复位明显丢失。Rasmussen膝关节功能评分:>27分7例,20～26分8例,17分1例,优良率为93.75%。结论治疗胫骨平台后柱骨折采用后内侧、后外侧入路可以直接暴露骨折,损伤小,可以对骨折进行有效的钢板支撑固定,疗效满意,是一种有效的治疗方法 。Objective To investigate the operative procedures and clinical outcomes of treating posterior column tibial plateau fractures with plate fixation via a posterior approach. Methods From January 2008 to September 2011, 16 patients with pure posterior column tibial plateau fractures were treated with plate fixation via a posterior approach. 11 patients were treated through a posterior medial approach. 5 patients were treated through a posterolateral approach. There were 12 males and 4 females, with an average age of 31.5 years old （range; 23-45 years）. Results All patients were followed up for an average period of 18 months （range; 6-31 months）. Bone union was obtained in all patients after an average of 3.8 months （range; 3-6 months）. No complications such as fracture, loosening, bending or significant loss of fracture reduction occurred in internal fixation with plates and screws. According to Rasmussen＇s criteria, 7 cases obtained excellent results （〉27 points）, 8 good （20-26 points）, 1 fair （17 points） and no poor case, with an excellent and good rate of 93.75%. Conclusions In the treatment of posterior column tibial plateau fractures through a posterior medial approach or posterolateral entrance approach, fractures can be directly exposed. Fracture fragments can be effectively fixed with supporting plates, with small injures and satisfactory clinical effects. It is an effective curative method.

关 键 词：胫骨平台 后柱 骨折 治疗 

分 类 号：R687.3[医药卫生—骨科学]