过伸型胫骨平台骨折的临床治疗分析  

Clinical Analysis of Hyperextension Tibial Plateau Fracture

作　　者：陈晓斌[1] 林宜磒 王晓伟[1] 征华勇 刘智 张建政[1] Chen Xiaobin;Lin Yiyun;Wang Xiaowei(Departmentof Orthopedics,The 7th Medical Center of PLA General Hopital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心骨科,北京100700

出　　处：《实用骨科杂志》2020年第10期880-883,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨过伸型胫骨平台骨折的特点及临床疗效。方法回顾性分析我院自2012年1月至2018年12月收治的16例过伸型胫骨平台骨折,男13例,女3例;年龄29~57岁,平均(40.1±6.8)岁。采用骨折切开复位取髂骨结构性植骨钢板固定术,血管损伤观察处理,软组织损伤行Ⅰ期或Ⅱ期修复。随访患者骨折愈合及复位后的维持情况、关节活动度和稳定性以及美国特种外科医院(the hospital special surgery,HSS)膝关节功能评分。结果16例随访时间8~22个月,平均(10.3±4.5)个月。骨折均愈合,愈合时间10~17周,平均(12.9±6.9)周。无骨折复位丢失,胫骨内翻角平均(86.4±2.6)°,后倾角平均(8.6±0.9)°;无明显膝关节不稳和疼痛;膝关节屈曲活动度125°~140°,平均(135.2±6.9)°;HSS评分88~97分,平均(90.2±3.1)分。结论过伸性胫骨平台骨折有其特殊性,充分认识其损伤机制并规范治疗可以取得良好的治疗结果,治疗过程中需关注血管及软组织损伤情况。Objective To investigate the characteristics and clinical treatment of tibial plateau hyperextension fracture.Methods From January 2012 to December 2018,sixteen cases of hyperextended tibial plateau fractures in our hospital were analyzed retrospectively,including 13 males and 3 females.The patients aged 29~57 years,withan average age of(40.1±6.8).The patients were treated with open reduction and structural iliac bone graft and plate fixation.Vascular injury was observed,and soft tissue injury was repaired in one or two stages.The patients were followed up for the fracture healing and maintenance of reduction,joint mobility and stability,and HSS score.Results The follow-up time was 8~22 months with an average of(10.3±4.5)months,and all the fractures healed.The healing time was 10~17 weeks with average(12.9±6.9)weeks.There was no loss of fracture reduction,tibial varus angle was(86.4±2.6)°and slope angle was(8.6±0.9)°,there was no obvious instability and pain of knee joint,flexion activity of knee joint was 125°~140°(135.2±6.9)°,and HSS was 88~97 points with anaverage of(90.2±3.1).Conclusion Hyperextension fracture of tibial plateau has its particularity.Satisfactory results can be obtained with fully understanding of the injury mechanism and standardized treatment procedure.During the treatment,more attention should be paid on the condition of blood vessels and soft tissuesinjury.

关 键 词：胫骨平台骨折 过伸损伤 血管损伤 

分 类 号：R683.42[医药卫生—骨科学]