23例SchatzkerⅥ型胫骨平台骨折的手术疗效分析  

Curative effect analysis of surgeries in 23 cases of Schatzker type VI tibial plateau fractures

作　　者：陈武[1] 

机构地区：[1]池州市人民医院骨科,安徽池州247000

出　　处：《中国骨与关节外科》2013年第3期266-269,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:SchatzkerⅥ型胫骨平台骨折治疗困难,膝关节常遗留严重的并发症,治疗方法尚存争议,多建议双接骨板固定。目的:评价SchatzkerⅥ型胫骨平台骨折的手术疗效。方法:2007年10月至2012年6月手术治疗23例SchatzkerⅥ型胫骨平台骨折。除1例行急诊手术外,其余22例的手术距受伤时间为5～23d,平均7.0d;采用膝前正中切口10例,Y行切口5例,前外侧联合后内侧切口8例;胫骨平台内外侧置锁定接骨板和传统普通接骨板内固定治疗。结果:全部获得随访,随访时间为7～33个月,平均18.3个月。术后骨折愈合时间为6～11个月,平均8.3个月。2例因膝前皮肤坏死行转移皮瓣修复。根据HSS膝关节临床功能评分法评估疗效,优5例,良11例,可4例,差3例。结论:术前充分准备,术中注意保护皮肤软组织和合理内固定,术后科学功能锻炼,SchatzkerⅥ型胫骨平台骨折的手术疗效满意。Background：Schatzker type Ⅵ tibial plateau fracture is very difficult to treat,serious complications often occur at the knee joint.The treatments remain controversial,and most scholars recommend the double plate fixation.Objective：To evaluate and analyze the curative effects of the surgeries for Schatzker type Ⅵ tibial plateau fractures.Methods：From October 2007 to June 2012,23 cases with Schatzker type Ⅵ tibial plateau fractures received the surgical treatment.Apart from 1 case of emergency operation,the rest 22 surgeries were performed 5 to 23 days after the injury,with a mean period of 7.0 days.10 cases received the anterior knee median incision,5 received the Y-shaped incision and 8 received the anterolateral and posteromedial joint incision.The internal fixation of placing both the locking plate and the traditional common plate at the medial and lateral sides of the tibial plateau were used in the treatment.Results：All patients were followed up for a mean period of 18.3 months（7 to 33 months）.And the mean fracture healing time was 8.3 months（6 to 11 months）.2 cases received the flap transposition repair because of a skin necrosis at the anterior knee.To assess the efficacy with HSS knee clinical function score,there were 5 excellent cases,11 good,4 fair and 3 bad.Conclusions：With adequate preoperative preparation,careful intraoperative protection of the skin and soft tissue,and scientific postoperative functional exercises,the curative effects of the surgery for Schatzker type Ⅵ tibial plateau fractures can be satisfactory.

关 键 词：胫骨平台骨折 SchatzkerⅥ型 

分 类 号：R687.3[医药卫生—骨科学]