腓骨近段骨折在后外侧柱复杂胫骨平台骨折中的参考意义  

Reference significance of proximal fibula fractures for selecting surgical procedures for complex tibial plateau fractures involving posterior lateral spine

作　　者：霍永峰[1] 殷照阳[1] 厉雷明[1] 于吉文[1] 顾光学[1] 孙晓[1] 

机构地区：[1]江苏省连云港市第一人民医院创伤骨科,222002

出　　处：《重庆医学》2015年第14期1921-1923,1927,共4页Chongqing medicine

摘　　要：目的探讨腓骨近段骨折对累及后外侧柱复杂胫骨平台骨折手术的参考意义。方法 69例累及后外侧柱的复杂胫骨平台骨折患者（Schatzker分型Ⅴ、Ⅵ型）,按术后即刻骨折复位质量Rasmussen评分进行筛选,筛选出评分为优且一般情况相似的39例,按是否伴有腓骨近段骨折和是否接受后外侧支撑钢板固定分为A1、A2和B1、B2组。A1组为未合并腓骨近段骨折但接受了后外侧支撑钢板固定,共10例;A2组为未合并腓骨近段骨折也未接受后外侧支撑钢板固定,共11例;B1组为合并有腓骨钢板近段骨折并接受后外侧支撑钢板固定,共9例;B2组为合并有腓骨近段骨折未接受后外侧支撑钢板固定,共9例。于随访12-14个月（平均12.8个月）时评定膝关节功能恢复情况,比较4组评分的相关性。结果 B1、B2两组美国特种外科医院膝关节评分（HSS评分）比较差异有统计学意义（P〈0.01）,而A1、A2两组HSS评分比较差异无统计学意义（P〉0.05）。结论伴有腓骨近段骨折并累及后外侧髁的复杂胫骨平台,手术中进行后外侧支撑钢板固定者康复后将获得更满意的效果。Objective To compare the effects proximal fibula fractures, and to explore the reference fracturesinvolvingposterior and lateral spine. Methods of two surgical procedures via comparison on tibial fractures with/without importance of proximal fibula fractures in surgery for complex tibial plateau Totally 69 cases of patients with complex tibial plateau fracturesinvolvingposterior and lateral spine （Schatzker V and VI） were selected,who accepted treatment between January 2008 and October 2012. The patients were screed according to the quality of fracture reduction immediately after operation. 39 cases were screened whose scores were excellent and the general condition was similar. The patients were divided into group A1, A2 and B1 and B2 according to the whether there was proximal fibula fractures and whether accepted posterior lateral support steel plate： group A1 （n= 10）： without proximal fibula fractures but with posterior lateral support steel plate;group A2 （n= 11） ：witho（at proximal fibula fractures and without posterior lateral support steel plate;group B1 （n = 9） ：with proximal fibula fractures and with posterior lateral support steel plate;group B2 （n= 9） ：with proximal fibula fractures but without posterior lateral support steel plate. According to the knee scoring system of American Hospital for Special Surgery （HSS）, a total of 39 eases of patients were followed up for 12--14 months （average 12.8 months） to evaluate the recovery condition of knee funotion. And correlations between the scores of the 4 groups were compared. Results There were statistically significant differences between group B1 and group 132 on HSS scores （P〈 0. 01） ,but there were not between group A1 and A2 （P〉0, 05）. Conclasion For patients with complex tibial plateau fracturesinvolvingposterior and lateral spine and with proximal fibula fractures, posterior lateral support steel plate can achieve more satisfactory rehabilitation function.

关 键 词：胫骨骨折 骨折固定 内 腓骨骨折 后侧入路 钢板 

分 类 号：R687.3[医药卫生—骨科学]