桥接组合式内固定系统治疗同侧胫骨干合并胫骨平台骨折的疗效分析  

Analysis of therapeutic effect of bridge-link type combined fixation system for ipsilateral tibial shaft and plateau fractures

作　　者：许遵营 肖棋 林金河 黄连水 徐维臻 吴进 XU Zunying;XIAO Qi;LIN Jinhe;HUANG Lianshui;XU Weizhen;WU Jin(Department of Orthopedics,the 909th Hospital of the Joint Logistic Support Force(the Affiliated Southeast Hospital to Xiamen University),Zhangzhou,Fujian363000,China)

机构地区：[1]九○九医院骨科,福建漳州363000

出　　处：《中国骨与关节损伤杂志》2024年第6期590-594,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨桥接组合式内固定系统(Bridge-link type combined fixation system,BCFS)治疗同侧胫骨干合并胫骨平台骨折的临床疗效。方法纳入自2018-06-2021-05采用BCFS治疗的14例同侧胫骨干合并胫骨平台骨折。术后每1~2个月定期复查X线片和体格检查,记录并发症发生情况、骨折愈合时间、疼痛VAS评分、Johner-Wruhs胫骨功能评分、膝关节活动度、HSS膝关节评分。结果14例均获随访,随访时间9~20个月,平均13.9个月。术后3例出现并发症,其中胫骨干肥大性骨折不愈合1例、感染1例、膝关节僵硬1例,胫骨干肥大性骨折不愈合和术后感染患者需行二次手术治疗。除2例因术后并发症需行二次手术外,其余12例术后完全负重活动时间为80~116 d,平均90.9 d;胫骨平台骨折愈合时间为10~18周,平均12.5周;胫骨干骨折愈合时间为20~40周,平均25周。末次随访时疼痛VAS评分0~3分,平均1.1分;Johner-Wruhs胫骨功能评分优9例,良4例,可1例;膝关节活动度105°~135°,平均121.8°;HSS膝关节评分90~96分,平均93.4分。结论应用BCFS治疗同侧胫骨干合并胫骨平台骨折的疗效确切,手术更加简便、微创,值得临床推广应用。Objective To explore the clinical efficacy of bridge-link type combined fixation system(BCFS)in the treatment of ipsilateral tibial shaft and plateau fractures.Methods Fourteen cases of ipsilateral tibial shaft and tibial plateau fractures treated with BCFS from June 2018 to May 2021 were included and followed up regularly with X-ray and physical examination every 1-2 months after surgery to record the occurrence of complications,fracture healing time,pain VAS score,Johner Wruhs tibial function score,knee joint range of motion,and HSS knee joint score.Results All fourteen cases were followed up for 9 to 20 months,with an average of 13.9 months.The postoperative complications occurred in three cases,including one case of non union of hypertrophic tibial shaft fracture,one case of infection,and one case of knee joint stiffness.Patients with non union of hypertrophic tibial shaft fracture and postoperative infection required secondary surgical treatment.Except for 2 cases who required a second surgery due to postoperative complications,the remaining 12 cases had a total postoperative weight-bearing activity time of 80-116 days,with an average of 90.9 days;The healing time of tibial plateau fractures was 10-18 weeks,with an average of 12.5 weeks;The healing time for tibial shaft fractures was 20-40 weeks,with an average of 25 weeks.At the last follow-up,the VAS score for pain was 0-3 points,with an average of 1.1 points:There were 9 cases of excellent,4 cases of good,and 1 case of fair in the Johner Wruhs tibial function score;The range of motion of the knee joint was 105°~135°,with an average of 121.8°;The HSS knee joint score ranged from 90 to 96,with an average score of 93.4.Conclusion The application of BCFS in the treatment of ipsilateral tibial shaft and tibial plateau fractures has a definite therapeutic effect,and the surgery is simpler and minimally invasive,which is worthy of clinical promotion and application.

关 键 词：同侧胫骨干合并胫骨平台骨折 桥接组合式内固定 经皮微创接骨术 MIPPO 快速康复 

分 类 号：R687.3[医药卫生—骨科学]