三柱理论在胫骨平台骨折治疗中的应用  

Application of three-column classification in tibial plateau fracture

作　　者：朱思强[1] 孔荣[1] 夏睿[1] 

机构地区：[1]安徽医科大学附属省立医院骨科,合肥230001

出　　处：《安徽医学》2015年第3期297-300,共4页Anhui Medical Journal

摘　　要：目的依据三柱理论指导胫骨平台骨折手术治疗,并评价其疗效。方法 25例胫骨平台骨折患者,根据三柱理论分为12例单柱骨折、11例双柱骨折和2例三柱骨折。根据三柱理论选择手术入路和内固定方式,术后随访评价临床疗效。结果单柱、双柱和三柱骨折的平均手术时间分别为102.32、123.73和150.27 min,平均随访时间为15.22个月,平均愈合时间为13.50周,平均完全负重时间为14.20周。25例患者术后12个月HSS平均评分为86.85分;膝关节活动度2.20°~122.50°,患者术后与12个月后的胫骨平台内翻角、后倾角差异无统计学意义(P>0.05)。结论三柱理论能较好地提高临床医师对胫骨平台骨折的认识,有效指导手术入路与内固定的选择,显著提高胫骨平台骨折的手术疗效。Objective To guide tibial plateau fracture surgery based on the three-column classification and to evaluate its clinical value. Methods From April 2012 to May 2013,a CT-based three dimensional classification,three-column classification,was used for determining the category and surgery approach in 25 cases of tibial plateau fracture. According to the three-column classification,there were 12one-column fractures,11 double-column fractures and 2 three-column fractures. Results The surgery of one-column,double-column and three-column fractures averagely need 102. 32,123. 73,150. 27 mines,respectively. All the cases were followed up for a mean time of15. 22 months with an average radiographic bone union time of 13. 50 weeks. The mean full weight-bearing time was 14. 20 weeks. The mean HSS score at 12 months postoperatively was 86. 85. The range of motion of the affected knee joints was 2. 20° to 122. 50°. There were no significant differences between immediate post ~ operation and 12 months in both tibial plateau angle and posterior slope angle( P > 0. 05). Conclusion The three-column classification can guide clinicians to have a general and three-dimensional cognition,and help to choose surgery approach and fixation. As a result,it can improve the surgical outcomes of tibial plateau fractures.

关 键 词：胫骨平台 骨折 三柱理论 手术入路 内固定 

分 类 号：R687.3[医药卫生—骨科学]