有限内固定联合外固定支架治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折  

Limited internal fixation combined with external fixator for treatment of Schatzker type Ⅴ,Ⅵ tibial plateau fractures

作　　者：刘潮坚[1] 石昭宏[1] 蔡拉加[1] 

机构地区：[1]潮州市中心医院骨外科,广东潮州521000

出　　处：《临床骨科杂志》2016年第2期214-216,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨有限内固定联合外固定支架治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的临床疗效。方法手术治疗55例SchatzkerⅤ型（31例）和Ⅵ型（24例）胫骨平台骨折患者。术中先透视下闭合复位或辅以小切口复位胫骨平台内外侧髁,并给予螺钉固定,再应用外固定支架固定,对塌陷骨折撬拨复位人工骨填充。结果骨折解剖复位39例,近解剖复位16例。患者均获得随访,时间12~54个月。骨折愈合时间4~7个月。末次随访膝关节功能按Rasmussen评分标准：优32例,良15例,可7例,差1例,优良率85.5%。切口并发症7例（12.7%）：其中切口浅表感染2例,钉道感染5例,未发生深部感染,骨髓炎及骨不连。结论有限内固定联合外固定支架治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折可获得满意临床疗效,具有创伤小、并发症发生率低、骨折愈合快等优点。Objective To summarize the clinical outcomes of limited internal fixation combined with external fixator for treatment of Schatzker type Ⅴ,Ⅵ tibial plateau fractures. Methods 55 patients with Schatzker type Ⅴ,Ⅵ tibial plateau fractures underwent surgical treatment. According to Schatzker classification,there were 31 patients of type Ⅴ and 24 patients of type Ⅵ. Firstly,the tibial lateral and medial condyle was closed reduction under C-arm fluoroscopy or supplemented by a small incision,and then used screws internal fixation,and then applied external fixation. Collapse fracture was treated by poking reduction and filled with artificial bone. Results There were 39 patients with anatomical reduction and 16 patients with nearly anatomical reduction. All patients were followed up for12 ~ 54 months,the fracture healing time was 4 ~ 7 months. At the final follow-up,there were 32 patients with excellent,15 good,7 fair and 1 poor,the excellent-good rate was 85. 5%,according to Rasmussen scores standard.Wound complications were occurred in 7 patients（ 12. 7%）,including 2 patients of superficial incision infection,5patients of pin site infection; none of patients with deep infection,osteomyelitis,and nonunion fractures was occurred. Conclusions The limited internal fixation combined with external fixator for treatment of Schatzker type Ⅴ,Ⅵ tibial plateau fractures can achieve satisfactory clinical and radiographic results,which has the advantage of less invasion,lower incidence rate of wound complication,and shorter time of fracture union.

关 键 词：胫骨平台骨折 有限内固定 外固定支架 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]