联合入路三柱钢板内固定治疗伴后髁劈裂高能量胫骨平台骨折  

Three-column internal fixation via combined approaches for high-energy tibial plateau fractures with posterior condyle separation

作　　者：王爱兵[1] 熊南平[1] 李坤庆[1] 明亮[1] 刘晟[1] 

机构地区：[1]江汉油田中心医院骨科,湖北433124

出　　处：《临床外科杂志》2013年第7期539-541,共3页Journal of Clinical Surgery

摘　　要：目的探讨联合入路三柱钢板内固定治疗伴后髁劈裂高能量胫骨平台骨折的临床疗效。方法应用前外侧、内侧、后内侧联合入路三柱钢板内固定治疗36例伴后髁劈裂高能量胫骨平台骨折，按改良Schatzker分型：Va-bc型16例，Vad—bc型9例，VIa—bc型7例，Ⅵad_hc型4例。结果36例患者获得随访，随访时间6～24个月，平均16个月。1例复位不完全并关节面一期塌陷，2例关节面二期塌陷，其余33例骨折愈合良好，愈合时间8—18周，平均12．6周。无切口感染和裂开、无内固定断裂、膝关节僵硬疼痛及其他并发症。按Lysholm评分标准：23例优，8例良，4例可，1例差，优良率86．1％。结论联合人路三柱钢板内固定治疗伴后髁劈裂高能量胫骨平台骨折，固定可靠，可早期进行功能活动，减轻了伤后关节功能受限的程度，并发症较少，疗效满意。Objective To study the clinical efficacy of three - column internal fixation via com- bined approaches for high - energy tibial plateau fractures with posterior condyle separation. Methods From January 2007 to December ：2011, a total of 36 patients of tibial plateau fractures with posterior con-dyle separation were treated via anterolateral, interior and posterointernal approaches. According to the classification of improved Schatzker,there were 16 cases of type Va-bc ,9 cases of type Vad-bc ,7 cases of type Via-be and 4 cases of type VIad-bc. Results The mean follow-up period was 16 months（ range 6 -24 ）. The radiographic bony union time was 12.6 weeks（ range 8 - 18 ）. One of the cases was resetted in- completely with articular surface collapsed in stage I ,two cases in stage Ⅱ and the rest of the 33 cases healed well. No infection, dehiscence, screw breakage, knee stiffness or soreness, and other complications oecured. According to the Lysholm scoring system,the results were excellent in 23 ,good in 8 ,fair in 4 and poor in 1. And the excellent and good rate was 86.1%. Conclusion The Three-column internal fixation via combined approaches for high-energy tibial plateau fractures with posterior condyle separation was reli- able. It can start early functional activities and reduce limitation of the joint function with fewer complica- tions and bettr efficacy satisfaction.

关 键 词：胫骨平台骨折 骨折固定术 联合入路 

分 类 号：R681.8[医药卫生—骨科学]