锁定加压钢板结合生物陶瓷治疗复杂胫骨平台骨折  

Complex tibial plateau fractures treated by locking compression plate combined with the bio-ceramic

作　　者：章建卫[1] 刘曦明[1] 蔡贤华[1] 汪国栋[1] 

机构地区：[1]广州军区武汉总医院骨科,武汉430070

出　　处：《中华创伤骨科杂志》2013年第7期567-570,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨锁定加压钢板（LCP）结合生物陶瓷治疗复杂胫骨平台骨折的疗效。方法2010年1月至2011年10月应用LCP结合生物陶瓷填充治疗43例复杂胫骨平台骨折患者，男24例，女19例；年龄19～77岁，平均41．2岁。骨折按Schatzker分型：Ⅴ型25例，Ⅵ型18例；骨折按三柱分型：三柱骨折29例，舣柱骨折14例。16例骨折分离移位严重的患者应用双侧LCP结合生物陶瓷填允固定，27例骨折分离移位不明显的患者应用单一外侧或内侧LCP结合生物陶瓷填允固定。术后支具或石膏保护4～6周。定期复查X线片，根据骨折愈合情况指导患者行渐进惟功能锻炼。按美国特种外科医院（HSS）膝关节功能评价标准评定疗效。结果所有患者平均手术时间为92min，术中平均出血量为220mL。所有患者获5～20个月（平均8．0个月）随访，42例患者术后12—16周骨折扶临床愈合。2例患者术后3d出现切口渗液现象，经过1周左右的换药治疗后渗液消失。1例发生慢性骨髓炎，终换药、清创治愈。按HSS膝关节功能评价标准评定疗效：优20例，良19例，中3例，差1例，优良率为90．7％。结论LCP结合生物陶瓷治疗复杂胫骨平台骨折并发症少、有效率高，是一种有效的办法。Objective To evaluate the clinical efficacy of treating complex tibial plateau fractures by locking compression plate （LCP） （：ombined with the bio-ceramic. Methods From January 2010 to October 2011, 43 patients with complex tibial plateau fractures were treated by 1,CP plus the bio-ceramic. They were 24 men and 19 women, 19 to 77 years of age （average, 41.2 years）. By the Schatzker classification, 25 cases were type V and 18 type VI： by the three-column classification, 29 eases were three-cohmm fractures and 14 double-column fi＇aetures. Bilateral LCP fixation plus the bio-ceramic fillir, g was performed in 16 patients with severe displacement a,ld separation while single lateral or medial LCP fixation plus the bio-ceramic filling was performed in 27 patients without severe displacement or separation. Brace or plaster protection was continued fOr 4 to 6 weeks. X-ray follow-ups were conducled regularly. Progressive funetional rehabilitation was encouraged gradually according to the fi＇acture healing of the patients. Clinical efficacy was evaluated according to the knee functional scoring of the Hospital for Special Surgery （HSS） syslem. Results The operative time averaged 92 minutes, and the intraoperative blood loss averaged 220 mL. All patients were followed up for 5 to 20 months （average, 8.0 months）. Clinical fracture healing was achieved in 42 patienls after 12 to 16 weeks postoperatively. Incision exudate was observed in 2 cases 3 days after operation but responded to one-week inlensive care. One case of chronic osteomyelitis occurred but was cured afire＂ dressing changes and dehridement. By HSS scores, 20 cases were excellent, 19 good, 3 moderate and one poor, giving an excellent and good tale of 90. 7%. Conclusion LCP plus the biu-eeramic is a good Ireatment of tibial plateau fractures, because it leads to fewer complications and high efficieney.

关 键 词：骨板 陶瓷制品 胫骨骨折 

分 类 号：R687.3[医药卫生—骨科学]