经内侧微创复位植骨术治疗胫骨平台SchatzkerⅢ型骨折的回顾性研究  

A retrospective study of Schatzker Ⅲ tibial plateau fracture using minimally invasive fixation and bone grafting through medial side

作　　者：凌志丹 王剑锋[1] 宋海波[1] 顾豪杰[1] 

机构地区：[1]海宁市中医院骨科,浙江海宁314400

出　　处：《中国骨伤》2015年第12期1114-1116,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：探讨采用特制金属棒经胫骨内侧微创复位植骨治疗胫骨平台SchatzkerⅢ型骨折的临床效果。方法：自2009年4月至2011年8月,采用特制金属棒经胫骨内侧微创复位植骨治疗胫骨平台SchatzkerⅢ型骨折18例,其中男15例,女3例;年龄64~73岁,平均（69.75±1.22）岁;摔伤16例,车祸伤2例。观察手术时间及切口长度。术后末次采用美国特种外科医院（the Hospital for Special Surgery,HSS）膝关节评分和骨关节炎Kellgren-Lawrence评分对疗效进行评定。结果：18例手术时间平均（45.32±1.58）min,手术切口长度平均（5.21±0.65）cm。术后影像学检查示骨折复位满意。18例均获随访,时间10~13个月,平均（11.50±1.35）个月。膝关节HSS评分总分86.51±2.71,其中优12例,良4例,中2例。3例为轻度骨关节炎。结论 ：采用特制金属棒经胫骨内侧微创复位植骨治疗胫骨平台SchatzkerⅢ型骨折,既将手术的创伤降到最小,又能保证关节的早期功能活动;同时能有效避免复位后的再丢失,具有良好的临床应用前景。Objective：To investigate clinical effects of minimally invasive fixation and bone grafting through medial side for the treatment of Schatzker Ⅲ tibial plateau fracture. Methods：From April 2009 to August 2011,18 patients with SchatzkerⅢtibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years,with an average of（69.75±1.22） years. Sixteen patients were caused by falling down,2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow up was performed after operation. Hospital for Special Surgery（HSS） score and Kellgren-Lawrence score were used to evaluate clinical effects. Results：The mean operative time was（45.32±1.58）min,and the mean length of incision was（5.21±0.65） cm. Postoperative X ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of（11.5±1.35） months. The mean HSS score was 86.51±2.71,12 cases got excellent results,4 good and 2 fair.Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system. Conclusion：Minimally invasive fixation and bone grafting through medial side,not only could reduce surgical invasive,but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.

关 键 词：胫骨平台骨折 外科手术 微创性 放射摄影术 

分 类 号：R683.42[医药卫生—骨科学]