经关节截骨治疗胫骨后外侧平台陈旧骨折畸形愈合  

Intra-articular Osteotomy for Posttraumatic Malunions of the Posterlateral Tibial Plateau Fracture

作　　者：徐亚风 罗从风[1] 张长青[1] 曾炳芳[1] 

机构地区：[1]上海市第六人民医院骨科,上海232000

出　　处：《实用骨科杂志》2015年第4期309-314,共6页Journal of Practical Orthopaedics

摘　　要：目的：探讨经关节截骨术治疗创伤后后外侧平台骨折畸形愈合的策略和临床效果。方法回顾2007年1月至2012年1月收治的创伤后后外侧平台骨折畸形愈合患者共28例，其中男15例，女13例；年龄28~59岁，平均42.6岁；左侧16例，右侧12例。按 Schatzker 分型，Ⅱ型19例，Ⅲ型 9例。保守治疗导致胫骨平台外翻塌陷畸形8例，创伤术后畸形愈合20例。所有患者入院后均行经关节截骨术。结果随访骨折均愈合良好，平均愈合时间为12~18周（平均14.7周）。术后即刻与术后2年胫骨平台内翻角及股胫角比较，差异无统计学意义（P〉0.05），所有患者术后膝关节稳定性及功能有明显改善。术后1例患者浅表感染经外科换药治愈，无骨不连，无内固定失效、松动、断裂。结论经关节截骨治疗创伤后后外侧平台骨折畸形愈合获得良好的治疗效果。Objective The aim of this study is to report the results of reconstructive osteotomies performed to treat mal-unions of the posterlateral tibial plateau fractures. Methods From 2005 to 2010,28 cases that have underwent valgus mal-union of the tibial plateau fractures. According to schatzker classification,there were 19 cases of type Ⅱ and 9 cares of typeⅢ. All patients underwent intra-articular osteotomy of the malunited tibial plateau fractures. 8 patients had been treated conser-vatively and 20 surgically. Results The mean bone union time was 12 ~ 18 weeks（average 14. 7 weeks）. There was no sig-nificant difference of TPA and FTA between postoperation and postoperation two years later. All patients were satisfied with their improvement in stability and knee function. Postoperatively,one patient had a superficial wound infection,which resolved with dressing. There were no nonunions and implant breakage or loosening. Conclusion Intra articular osteotomy can provide satisfactory results with posttraumatic malunions of the posterlateral tibia plateau fractures.

关 键 词：胫骨平台骨折 后外侧 畸形愈合 经关节截骨 

分 类 号：R683.42[医药卫生—骨科学]