三柱内固定在治疗复杂胫骨平台骨折中的应用  

The application of three-column internal fixation in the treatment of complex fractures of tibial plateau

作　　者：胡靖[1] 汪建军[1] 刘立明[1] 陈义[1] 

机构地区：[1]安徽医科大学附属安庆医院骨科,安庆246000

出　　处：《南通大学学报（医学版）》2013年第2期104-106,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:探讨复杂胫骨平台骨折三柱内固定的治疗效果。方法:以CT三维重建为基础,将13例累及胫骨平台内外侧柱及后柱的复杂胫骨平台骨折经内外侧联合手术入路行三柱内固定,术中骨缺损取自体髂骨或同种异体骨进行植骨,术后早期行功能锻炼以尽量取得良好的功能恢复。结果:13例患者均获得随访,平均随访19.8个月。术后即刻X线片示13例全部解剖复位,术后随访全部骨折均临床愈合,无骨不连、内固定松动断裂等并发症发生。按Rasmuseen评分标准,本组资料显示功能恢复优10例,良2例,可1例,差0例,优良率92.3%。结论:对于累及内侧柱、外侧柱及后柱的复杂胫骨平台骨折采取三柱内固定可取得良好的复位及牢固的固定,利于患者术后早期锻炼及功能恢复,取得良好的治疗效果。Objective： To explore the curative effect of three-column internal fixation in the treatment of complex fractures of tibial plateau. Methods： Based on CT three-dimensional reconstruction, 13 cases of complex fractures of tibial plateau involving the medial and lateral columns and posterior column were fixed internally by using the medial and lateral combined surgery approach. The autogenous iliac bone or allogeneic bone was selected for bone grafting in cases of bony defect during the surgery. Postoperative functional exercises were carried out as early as possible in order to obtain good functional recovery. Results： The 13 patients were all followed up for 19.8 months on average. Immediate postoperative X-rays showed that all the 13 cases had anatomic reduction, the postoperative follow-up showed all the cases with fractures had obtained clinical healing, and no complications such as bone nonunion, intemal fixation loosening and breakage cases occurred. According to the Marking Standard of Rasmuseen, our data demonstrated the result of functional recovery： excellent in 10 cases, good in 2 cases, fair in 1 case and poor in 0 case. The excellent rate was 92.3%. Conclusion： The three-column intemal fixation in the treatment of complex fractures of tibial plateau involving the medial and lateral columns and posterior column can obtain good restoration and rigid fixation, promoting the early postoperative exercises and functional recovery of patients and helping to achieve good therapeutic effect.

关 键 词：胫骨平台粉碎性骨折 三柱分型 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]