四柱理念治疗SchatzkerⅠ~Ⅳ型胫骨平台骨折的临床疗效分析  

Clinical efficacy observation of the four-column concept in the treatment of Schatzker type I-IV tibial plateau fractures

作　　者：袁胜超 李征[1] 林馥纯[2] 吴云飞 YUAN Shengchao;LI Zheng;LIN Fuchun;WU Yunfei(Department Orthopedic,Dongguan Hospital,Guangzhou University of Traditional Chinese Medicine,Dongguan 523000,Guangdong,China;Functional Examination Section,Dongguan Hospital,Guangzhou University of Traditional Chinese Medicine,Dongguan 523000,Guangdong,China)

机构地区：[1]广州中医药大学东莞医院骨科,广东东莞523000 [2]广州中医药大学东莞医院功能检查科,广东东莞523000

出　　处：《中国现代医生》2025年第2期37-40,共4页China Modern Doctor

基　　金：广东省东莞市社发一般项目(20221800900012)。

摘　　要：目的通过分析四柱理念与Schatzker分型理念在Ⅰ~Ⅳ型胫骨平台骨折治疗方面的影像学结果和临床疗效,评估该理念的有效性和实用性。方法选取2022年9月1日至2023年4月30日广州中医药大学东莞医院70例胫骨患者作为研究对象,按照手术方式分为治疗组和对照组,每组35例。所有患者接受完整的X线和CT三维重建检查,术后进行定期的膝关节X线正侧位片复查。比较两组术后1个月和术后1年的胫骨平台后倾角(posterior tibial slope,PTSA)、胫骨平台内翻角(tibial plateau anterior,TPA)、关节面继发移位的测量及视觉模拟评分法(visual analogue scale,VAS)评分、膝伸屈活动范围(range of motion,ROM)、Lysholm膝关节评分量表(Lysholm knee score scale,LKSS)评分。结果治疗组患者的手术时间和出血量少于对照组,差异有统计学意义(P<0.05),两组患者的膝伸屈ROM、Lysholm评分在术后1个月比较,差异有统计学意义(P<0.05)。两组患者在术后1个月和1年时的PTSA、关节面继发塌陷比较,差异有统计学意义(P<0.05)。结论四柱理念指导下行SchatzkerⅠ~Ⅳ型胫骨平台骨折手术治疗能有效恢复骨折端对位对线和固定强度,改善膝关节活动度,值得在临床中推广应用。Objective To assess the validity and utility of the four-column concept by comparing the imaging results and clinical efficacy of the four-column concept with the Schatzker typing concept in the treatment of type I-IV tibial plateau fractures.Methods A total of 70 tibial plateau fracture patients selected from Dongguan Hospital,Guangzhou University of Traditional Chinese Medicine from September 1,2022 to April 30,2023,who were divided into treatment group and control group,with 35 patients in each group.All patients underwent complete X-ray and CT three-dimensional reconstruction examination,and regular postoperative review of orthopantomograms of the knee was performed.Data were collected at 1 month and 1 year postoperatively,including measurements of posterior tibial slope(PTSA),tibial plateau anterior(TPA),and secondary displacement of the articular surfaces,as well as the visual analogue scale(VAS),range of motion(ROM),and Lysholm knee score scale(LKSS).Results The operation duration and bleeding volume in treatment group were less than that in control group,and the difference were statistically significant(P<0.05).There were significant differentes at 1 month after postoperatively in knee ROM and Lysholm scores between two groups(P<0.05).There were significant differences in PTSA and articular surface collapse at 1 month and 1 year postoperatively(P<0.05).Conclusion Surgical treatment of Schatzker type I-IV tibial plateau fracture under the guidance of the four-column concept can effectively restore the alignment of fracture ends and fixation strength,and improve the mobility of the knee joint,which is worthy of popularization and application in the clinic.

关 键 词：四柱理念 SCHATZKER分型 胫骨平台骨折 

分 类 号：R687[医药卫生—骨科学]