镍钛记忆合金弓齿钉辅助锁定钢板内固定治疗粉碎性胫骨平台骨折  

Treatment of comminuted fracture of tibial plateau with Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation

作　　者：王延祥 章云童[2] 汤洋[2] 赵雪[2] 付青格[2] 张欣[2] 张春才[2] 

机构地区：[1]微山县人民医院骨科,山东微山277600 [2]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国骨伤》2013年第7期601-604,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨镍钛记忆合金弓齿钉辅助锁定钢板内固定治疗粉碎胫骨平台骨折的临床疗效。方法:自2003年1月至2008年12月,采用镍钛记忆合金弓齿钉辅助锁定钢板内固定治疗17例粉碎性胫骨平台骨折患者,男9例,女8例;年龄23～48岁,平均33.7岁;均为伤后3周内手术的新鲜骨折。按Schatzker分型:Ⅴ型1例,Ⅵ型16例。2例同时伴有腓总神经损伤。结果:17例全部获随访,随访时间10～22个月,平均18个月。切口均Ⅰ期愈合。术后3～12周16例患者伸屈膝关节达健侧水平,1例患者屈膝功能稍差。术后3～5个月均获骨性愈合,1年后取出内固定,均未发生骨折复位丢失或再骨折。至末次随访未发现骨块移位、内置物松动、断裂等并发症发生。按照胥少汀膝关节功能综合评分标准:优9例,良4例,中4例。结论:镍钛合金记忆弓齿钉的设计适应胫骨上段不规则的解剖结构,持续应力加压作用可促进骨质愈合,多点锁定可避免局部软组织大范围剥离,结合锁定钢板形成三维空间固定,有效地恢复解剖结构,是治疗粉碎性胫骨平台骨折的有效方法。Objective：To assess the clinical effects of Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation in treating comminuted fracture of tibial plateau. Methods：From January 2003 to December 2008,17 patients with comminuted fracture of tibial plateau were treated with Ni-Ti shape memory alloy bow-teeth screws and locking plate internal fixation. There were 9 males and 8 females with an average age of 33.7 years old （ranged,23 to 48 years）. All fractures were fresh and injured time less 3 weeks and 2 patients with common peroneal nerve injury. According to Schatzker typing,type Ⅴ was in 1 case and type Ⅵ was in 16 cases. Results：All patients were followed up from 10 to 22 months with an average of 18 months and all incisions healed in one stage. At 3 to 12 weeks after operation ,knee joint function of 16 cases arrived to the level of uninjured side and 1 case was poor in flexed function. All fractures obtained union at 3 to 5 months after operation,and internal fixtures were removed at 1 year after operation and no reduction lossing or refracture occurred. At final follow up,no bone block shifting,internal fixture loosening and breakage was found. According to the standard of Xushanding ＇ s knee joint function,9 cases got excellent results,4 good,4 fair. Conclusion：The design of Ni-Ti shape memory alloy bow-teeth screws is adapt to irregular anatomic structure of comminuted fractures of tibial plateau ,it can continuously pressurize and promote bone healing. Multi drop lockedup may avoid wide ranging stripping local soft tissue,and form three dimension fixation after combined with locking plate internal fixation,can effective recover anatomic structure of fracture. So Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation is an effective method in treating comminuted fracture of tibial plateau.

关 键 词：胫骨平台骨折 骨折 粉碎性 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学]