经改良腓骨小头上入路L型钢板治疗累及后外侧髁的胫骨平台外侧骨折的临床研究  

Treatment of Lateral Tibial Plateau Fracture Combined with Posterolateral Condyle Fracture by Single L-Shaped Plate

作　　者：赵智勇 姜士超 徐鹏[2] 穆卫东[2] ZHAO Zhi-yong;JIANG Shi-chao;XU Peng;MU Wei-dong(Cheeloo College of Medicine,Shandong University,Jinan 250000,China;Department of Trauma Orthopaedies,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250000,China)

机构地区：[1]山东大学齐鲁医学院,济南250000 [2]山东大学附属山东省立医院创伤骨科,济南250000

出　　处：《骨科》2022年第2期130-134,共5页ORTHOPAEDICS

摘　　要：目的探讨单一L型钢板治疗累及后外侧髁的胫骨平台外侧骨折的临床疗效。方法回顾性分析2016年10月至2021年3月山东大学附属山东省立医院收治的23例累及后外侧髁的胫骨平台外侧骨折病人的临床资料,其中男12例,女11例,年龄为22~73岁,平均40.5岁。受伤原因:高处坠落10例,交通事故10例,重物挤压3例,均为闭合性骨折。病人受伤至入院时间为2~72 h,入院至手术时间为3~14 d。均采用改良的腓骨小头上入路,骨折复位后L型钢板固定,一期处理合并前交叉韧带及半月板损伤。末次随访采用美国特种外科医院(American Hospital for Special Surgery,HSS)膝关节评分评价膝关节功能。结果平均手术时间为53 min(45~71 min),平均术中出血量为122 m L(55~150 m L),平均随访时间为16.1个月(11~20个月)。X线复查结果示骨折均愈合,愈合时间为12~17周。末次随访时膝关节伸直度为0°~35°,膝关节屈曲度为100°~150°,HSS评分平均为92.2分(81~100分)。结论单一L型钢板可以同时有效地固定胫骨平台后外侧髁及外侧骨折块,手术操作简便,可获得较好疗效。Objective To investigate the results of treatment of lateral tibial plateau fractures combined with posterolateral condyle fracture by using single L-shaped plate.Methods From October 2016 to March 2021,23 cases of lateral tibial plateau fractures combined with posterolateral condyle fracture were treated.There were 12 males and 11 females.The age ranged from 22 to 73 years old,with an average of 40.5years old.There were 10 cases caused by traffic accident,10 cases caused by falling and 3 cases caused by heavy pound,all of which were closed fractures.The time from injury to admission was 2-72 h.The time from admission to operation was 3-14 d.All cases underwent fracture reduction and fixation by L-shaped plate through the modified superior fibular head approach,and associated anterior cruciate ligament and meniscal injury was treated.Knee function was evaluated by American hospital for special surgery(HSS)knee score at last follow-up.Results The average operation time was 53 min(45-71 min),and the average intraoperative blood loss was 122 m L(55-150 m L).The average followed up time was 16.1 months(11-20 months).All healed fractures were shown on X-ray image,and the healing time was 12-17 weeks.The knee extension angle at the last follow-up was 0°-35°,and flexion angle was 100°-150°.The HSS score was 92.2(81-100).Conclusion Single L-shaped plate can effectively fix lateral fracture of the tibial plateau combined with posterolateral condyle fracture.This surgical technique is simple and safe,and can achieve a good outcome.

关 键 词：胫骨平台外侧骨折 后外侧髁 L型钢板 

分 类 号：R687.3[医药卫生—骨科学]