排钉内固定结合植骨治疗胫骨平台骨折的疗效分析  

Strip nail internal fixation with bone graft for the treatment of tibial plateau fracture

作　　者：陈道振[1] 赵志坚[1] 陈坤峰[1] 徐继胜[1] 

机构地区：[1]商丘市第一人民医院创伤外科,河南商丘476100

出　　处：《中国骨伤》2015年第12期1102-1105,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨排钉内固定结合植骨治疗胫骨平台骨折的临床疗效。方法：回顾性分析2012年5月至2014年5月收治且获得随访的36例胫骨平台骨折患者的临床资料,男25例,女11例;年龄17~65岁,平均43.5岁。受伤至手术时间3~10 d,平均5.8 d。所有患者采用L形或T形骨板排状螺钉内固定结合植骨方法治疗。末次随访时按照美国特种外科医院膝关节功能评分法评定疗效。测量比较患者术后3 d与术后1年的胫骨平台内翻角、后倾角及股胫角。结果：36例患者的手术时间平均（2.2±0.6）h,术中出血量平均（310.5±36.2）ml,住院时间平均（14.8±2.7）d。36例患者术后获随访,时间12~30个月,平均18.2个月。骨折愈合时间4~8个月,平均6.2个月。36例患者术后3 d与术后1年的胫骨平台内翻角、后倾角及股胫角比较差异无统计学意义。末次随访时按照美国特种外科医院膝关节功能评分法评定疗效：优18例,良13例,中4例,差1例。结论：采用排钉内固定结合植骨治疗胫骨平台骨折可有效预防关节面二次塌陷,达到解剖复位、坚强固定及早期进行功能锻炼的目的,效果满意。Objective：To investigate surgical outcomes of strip nail internal fixation with bone graft in treating tibial plateau fracture. Methods：From May 2012 to May 2014,36 patients with tibial plateau fracture were retrospectively analyzed,including 25 males and 11 females with an average age of 43.5（ranged from 17 to 65） years old. The time from injury to operation ranged from 3 to 10 days with an average of 5.8 days. All patients were treated with L shaped and T shaped strip nail internal fixation with bone graft. It was evaluated by the Knee Functional therapy assessment method of the Special Surgical Hospital of American at final following up. Varus angle,caster angle and femorotibial angle were recorded and compared at 3 days and 1 year. Results：Operative time was（2.2±0.6） h on average,blood loss was（310.5±36.2） ml on average,hospital stay was（14.8±2.7） days on average. Thirty six patients were followed up from 12 to 30 months with an average of 18.2 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The difference is not significant among varus angle,caster angle and femorotibial angle at 3 days and 1 year. According to the knee functional therapy assessment method of the Specialized Surgical Hospital of American,18 cases got excellent results,13 good,4 moderate and 1 poor. Conclusion：Strip nail internal fixation with bone graft for the treatment of tibial plateau fracture could effectively prevent the joint surface from secondary collapse,and achieve anatomic reduction,stable fixation and earlier functional exercise in further to get satisfied clinical effects.

关 键 词：胫骨平台骨折 植骨 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学]