涉及后柱胫骨平台骨折的不同治疗策略  

Different treatment strategies for tibial plateau fractures with posterior column fractures

作　　者：林成寿[1] 林旺[1] 许胜贵[1] 郭卫中[1] 苏郁[1] 柯勇平[1] 王磊[1] 刘寿坤[1] 

机构地区：[1]福建医科大学附属闽东医院(宁德市闽东医院)骨科,福建福安355000

出　　处：《中国骨与关节损伤杂志》2016年第8期817-820,共4页Chinese Journal of Bone and Joint Injury

基　　金：福建省自然科学基金资助项目(2012J01438)

摘　　要：目的探讨涉及后柱胫骨平台骨折的治疗策略。方法自2009-07-2014-10收集206例胫骨平台骨折的临床资料，研究涉及后柱的胫骨平台骨折的发病率。采用Sehatzker法及罗从风三柱法分别对骨折进行分类。后柱再分为后内侧柱和后外侧柱，筛选出涉及后柱的胫骨平台病历。根据后柱骨折的类型，选择合适的手术方案。结果206例获得随访平均15．6（12-36）个月。150例骨折涉及后柱，其中130例涉及后外侧柱。97例涉及后内侧柱。206例无一例出现血管、神经损伤、内固定物松动及断裂，术后12个月复查骨折均获得骨性愈合。术后1年复位不良者3例。结论涉及后柱的胫骨平台骨折发病率高，应根据骨折类型，采用合适的切口、内固定方式等，以获得良好治疗效果。Objective To investigate suitable treatment strategies for tibial plateau fractures with posterior column fractures. Methods Between July 2009 and October 2014, the data of 206 patients with tibial plateau fractures in our hospital was collected to analyze the incidence of posterior column fractures. Schatzker classification and three-column classification were respectively used to classify the fracture types. The posterior column was divided into posterolateral and posteromedial column. The cases of posterior column fracture were screened. The suitable operation plans were selected according to the types of posterior column fracture. Results The average follow-up of 206 cases was 15.6 （range, 12-36）months. The posterior column fractures were founded in 150 cases. The posterolateral column was involved in 130 cases and the posteromedial column was involved in 97 cases. No vascular damage, nerve damage, loosening and breakage of internal fixators were found in all cases. All the cases obtained bony union at 12 months postoperatively. There were 3 cases with malreduction. Conclusion The incidence of tibial plateau fractures with posterior column fractures is high. The suitable incisions and internal fixation methods are chosen to treat the fractures according to different fracture types, and achieve satisfactory clinical effect.

关 键 词：胫骨平台骨折 后柱 SCHATZKER分型 三柱分类法 

分 类 号：R687.3[医药卫生—骨科学]