胫骨结节截骨入路治疗股骨远端C_(3)型骨折  

Tibial tuberosity osseotomy approach for C_(3) distal femoral fracture

作　　者：李腾 赵志坚[1] LI Teng;ZHAO Zhi-jian(Department of Emergency,Shangqiu First People’s Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院急诊外科,河南商丘476000

出　　处：《黑龙江医药科学》2022年第2期34-35,共2页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探讨经胫骨结节截骨治疗股骨远端C_(3)型骨折的疗效及并发症。方法:2015-01~2017-01共18例股骨髁间C_(3)型骨折患者,采用胫骨结节截骨、股骨外侧解剖锁定钢板治疗股骨髁间粉碎性骨折(C_(3)型),术后1个月、3个月、6个月及12个月复查膝关节正侧位X线,了解骨折愈合情况,以及膝关节功能评分(HSS评分),VAS评分。结果:随访时间平均26个月。共出现3例创伤性关节炎,1例膝关节僵硬,1例内固定螺钉遗留。无髌韧带止点的撕脱骨折、膝关节感染。HSS评分(87±2.1)分,VAS评分(0.2±0.1)分。此术式效果优良。结论:胫骨结节截骨可显著增加股骨远端的手术视野的显露范围,并且可在单一切口内完成股骨髁上合并股骨髁间骨折的复位内固定操作,并且并发症较少,可作为复杂膝关节周围骨折的入路选择。Objective:To explore the complications and clinical outcome of a novel approach through tibial tubercle osteotomy for anatomic locking plate fixation of complicated femoral intercondyle fractures.Methods:18 cases who had complicated femoral intercondylar fracture classified as AO C received the open reduction and inter fixation through tibial tubercle osteotomy during January 2015 to January 2017.X-ray was carried out to access the bone healing and the hospital for special knee score(HSS)and Visual Analogue Score(VAS).Results:18 cases were followed up for an average of 26 months.3 patients has traumatic arthritis.1 patient has knee stiffness.One has a screw left in bone.None avulsion fracture and knee joint infection.HSS score is(87±2.1),VAS is(0.2±0.1).Conclusion:Tibial tubercle osteotomy could intensely expand the extent of the surgical field of the distal femur and ensure that complete the reduction and internal fixation of the femoral condyle and femoral intercondylar fracture in a single incision.It can be used as pathway select for complex periarticular fractures.

关 键 词：股骨髁间骨折 股骨髁上骨折 胫骨结节截骨 股骨远端骨折 

分 类 号：R683.42[医药卫生—骨科学]