复杂胫骨平台骨折的改良Schatzker分型  

Modified Schatzker classification of the complex tibial plateau fractures

作　　者：刘飞 刘曦明[2] 蔡贤华[2] 闫威[2] 黄进成[2] 潘昌武[2] 

机构地区：[1]南漳县人民医院工作 [2]武汉,广州军区武汉总医院骨科,430070

出　　处：《中华创伤骨科杂志》2014年第10期867-872,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 提出复杂胫骨平台骨折的改良Schatzker分型,探讨其临床应用价值，方法 根据胫骨平台骨折端有无垂直压缩,将2010年5月至2013年10月收治的205例SchatzkerⅤ、Ⅵ型胫骨平台骨折患者各自进一步分出2种亚型：垂直压缩型（Ⅴa型27例、Ⅵa型39例）66例和非垂直压缩型（Ⅴb型42例、Ⅵb型97例）139例，所有患者均行手术治疗,并比较垂直压缩和非垂直压缩型患者的各项主要临床指标：性别、年龄、损伤侧别、受伤机制、是否存在合并伤、肢体短缩长度、受伤至手术时间、手术时间、手术出血量、手术入路、手术复位情况、术后负重时间和美国特种外科医院（HSS）膝关节评分， 结果 205例患者术后获7 ～32个月（平均18.5个月）随访.Schatzker Ⅴa、Ⅵa型胫骨平台骨折患者的性别、损伤侧别、手术复位情况、术后HSS膝关节评分的优良率分别与Schatzker Ⅴb、Ⅵb型患者进行比较,差异均无统计学意义（P＞0.05）,而在年龄、受伤机制、是否存在合并伤、肢体短缩长度、受伤至手术时间、手术时间、手术出血量、手术入路、术后负重时间等方面,差异均有统计学意义（P＜0.05），结论 改良Schatzker分型能反映复杂垂直压缩型胫骨平台骨折的临床特点,可为其治疗提供个性化的治疗方案。Objective To analyze the clinical value of self-modified Schatzker classification of complex tibial plateau fractures.Methods From May 2010 to October 2013,205 patients with complex tibial plateau fracture of Schatzker type Ⅴ or Ⅵ were treated by surgery in our department.Their fracture types were further sub-classified into vertical compression subtype （subtype Ⅴ a in 27 cases and subtype Via in 39 cases） and no vertical compression subtype （subtype Ⅴb in 42 cases and subtype Ⅵb in 97 cases） according to the presence of vertical compression at the fracture ends.All patients were analyzed in terms of clinical variables,including gender,age,injury side,injury mechanism,associated injury,limb shortening length,time from injury to operation,operation time,blood loss,surgical approach,reduction,time for weight-bearing,and The Hospital for Special Surgery （HSS） score.Results 205 patients won follow-up from 7 to 32 months （average,18.5 months）.There were no significant differences between subtypes a （Ⅴa and Ⅵa） and subtypes b （Ⅴb and Ⅵb） in gender,injury side,reduction,or HSS score （P ＞ 0.05）,but there were significant differences in age,injury mechanism,associated injury,limb shortening length,time from injury to operation,operation time,blood loss,surgical approach and time for weight-bearing （P ＜0.05）.Conclusion Our modified Schatzker classification of the complex tibial plateau fractures can reflect the major clinical characteristic of the complex tibial plateau fractures,vertical compression at the fracture ends,and therefore,it can help individualized treatment.

关 键 词：膝关节 胫骨骨折 骨折 压缩性 改良Schatzker分型 

分 类 号：R687.3[医药卫生—骨科学]