新型玻璃骨植骨微创治疗胫骨平台骨折的初步疗效  

Short-term outcomes of rod-shaped glass bone graft for treatment of tibial plateau fracture

作　　者：郑占乐[1] 刘欢[1] 邢欣[1] 周汇霖 连晓东[1] 张英泽[1] Zheng Zhanle;Liu Huan;Xing Xin;Zhou Huilin;Lian Xiaodong;Zhang Yingze(Trauma Emergency Center,The Third Hospital of Hebei Medical University,Key Laboratory of Orthopaedic of Hebei Province,Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北医科大学第三医院创伤急救中心,河北省骨科重点实验室,河北石家庄050051

出　　处：《中华创伤骨科杂志》2019年第5期455-460,共6页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(81702139);河北省自然科学基金(H2018206223).

摘　　要：目的探讨自行研制的棒状玻璃骨植骨治疗胫骨平台骨折的初步疗效。方法回顾性分析2019年1月至2019年2月于河北医科大学第三医院创伤急救中心应用微创复位加新型玻璃骨条植骨治疗的4例胫骨平台患者资料。男2例,女2例;年龄31~67岁,平均42岁;左侧3例,右侧1例。按照Schanzker分型:Ⅱ型3例,Ⅲ型1例;依据张氏胫骨平台骨折综合分型,均为Ⅰ型。所有患者在全身麻醉下通过张氏牵引复位器和自制的顶棒复位骨折,选择合适大小的玻璃骨棒沿骨隧道植入。透视结果满意后使用小切口置入接骨板,再次透视验证后缝合切口。术中进行关节镜检查,测量骨折移位程度,记录每位患者的手术时间、切口长度、置入导针所需的透视次数、术中出血量、术后短期并发症发生率。结果4例患者平均手术时间37.5 min,切口总长度平均7.0 cm,置入导针所需透视次数平均为8.8次,术中出血量40.0 mL。所有患者切口均一期愈合,有2例患者术后出现小腿肌间血栓,无术后感染病例,无相关并发症发生。结论张氏微创复位法结合自行研制的棒状玻璃骨植骨治疗胫骨平台骨折的初步效果肯定,但还需要进一步扩大病例,延长随访时间,从而获得更加可靠的研究结论。Objective To analyze the short-term outcomes of rod-shaped glass bone graft for the treatment of tibial plateau fracture.Methods From January 2019 to February 2019,4 patients with tibial plateau fracture underwent minimally invasive reduction and new glass bone graft at Trauma Emergency Center,The Third Hospital of Hebei Medical University.They were 2 men and 2 women,aged from 31 to 67 years(average,42 years).The fractures happened at 3 left sides and one right side.According to Schanzker's classification,3 cases were typeⅡand one case was typeⅢ.According to Zhang's classification for tibial plateau fractures,they were all typeⅠ.The reduction was carried out under general anesthesia by a Zhang's traction device and a self-made rod.A rod-shaped glass bone graft of appropriate size was implanted along the bone tunnel.The plate was implanted through small incisions after fluoroscopy results were satisfactory.Intraoperative arthroscopic examination was used to assess fracture displacement before wound closure.The operation time,incision length,fluoroscopic frequency for insertion of guide needle,intraoperative blood loss,and short-term postoperative complications were recorded for each patient.Results The operation time for the patients averaged 37.5 min,the total length of all incisions 7.0 cm,the fluoroscopy required for insertion of guide needle 8.8 times,and the intraoperative blood loss 40.0 ml.All incisions were healed by the first intention.Postoperative intermuscular thrombosis occurred in 2 cases.No postoperative infection or related complications happened.Conclusion Rod-shaped glass bone graft can lead to positive short-term outcomes for tibial plateau fractures,but a more reliable conclusion necessitates further clinical trials with a large sample size and long-term follow-up.

关 键 词：膝关节 外科手术 微创性 植骨 胫骨平台骨折 玻璃骨 

分 类 号：R687.3[医药卫生—骨科学]