外固定支架结合胫骨近端锁定钢板治疗胫骨平台复杂骨折
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作者Author单位AddressE-Mail
田坤 TIAN Kun 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China tiank2088@163.com 
端木群力 DUANMU Qun-li 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
倪凌之 NI Ling-zhi 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
黄东辉 HUANG Dong-hui 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
梅正峰 MEI Zheng-feng 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
瞿杭波 QU Hang-bo 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
雷文涛 LEI Wen-tao 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
朱红 ZHU Hong 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
韩乙庭 HAN Yi-ting 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
马伟 MA Wei 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
赵琦辉 ZHAO Qi-hui 杭州市第三人民医院骨科,浙江 杭州 310009 Department of Orthopaedics,Hangzhou Third People's Hospital,Hangzhou 310009,Zhejiang,China  
期刊信息:《中国骨伤》2009年,第22卷,第8期,第618-620页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:通过应用外固定支架结合胫骨近端锁定钢板治疗胫骨平台骨折,观察临床疗效,探讨胫骨平台复杂骨折的治疗方法。

方法:2006年2月至2008年10月,采用外固定支架结合胫骨近端锁定钢板治疗复杂胫骨平台骨折12例,男8例、女4例;年龄23~59岁,平均38岁。骨折按Schazker分型:Ⅴ型7例,Ⅵ型5例。术中使用前内侧切口及前外侧切口,于胫骨外侧置入锁定钢板进行内固定。观察术前及术后X线片胫骨平台塌陷及高度丢失情况,对膝关节功能使用HSS评分法评分。

结果:12例均获随访,时间4~18个月,平均9.79个月,骨折平均愈合时间3.1个月。骨折愈合11例,延迟愈合1例,无骨筋膜室综合征及下肢深静脉栓塞。术前、术后X线片对照检查未发生Ⅱ期胫骨平台塌陷及高度丢失,无对线不良,膝关节屈曲90°~110°。HSS评分术后平均(75.50±10.01)分,较术前平均(21.50±11.68)分有所提高。

结论:外固定支架结合胫骨近端锁定钢板治疗复杂胫骨平台骨折提供了持续稳定的固定,防止骨折的Ⅱ期移位和膝关节力线的畸形,可以保护膝关节周围软组织,减少手术并发症,膝关节功能满意。
【关键词】胫骨平台骨折  骨折固定术,内  支架(骨科)
 
Surgical treatment of tibia plateau fractures with external fixator and the locking plate
ABSTRACT  

Objective: To observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate.

Methods: From Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type,7 cases were typeⅤand 5 cases were type Ⅵ。 Using an anteromedial incision and an anterolateral approach,the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring.

Results: These patients were followed up for 4 to 18 months(means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90°to 110°。 The HSS knee functional scoring was(75.50±10.01)scores after operation and(21.50±11.68) scores before operation.

Conclusion: The treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change,protect the soft-tissue around the knee,reduce the postoperative complications. The knee joint function is satisfied.
KEY WORDS  Tibial plateau fracture  Fracture fixation,internal  Braces
 
引用本文,请按以下格式著录参考文献:
中文格式:田坤,端木群力,倪凌之,黄东辉,梅正峰,瞿杭波,雷文涛,朱红,韩乙庭,马伟,赵琦辉.外固定支架结合胫骨近端锁定钢板治疗胫骨平台复杂骨折[J].中国骨伤,2009,22(8):618~620
英文格式:TIAN Kun,DUANMU Qun-li,NI Ling-zhi,HUANG Dong-hui,MEI Zheng-feng,QU Hang-bo,LEI Wen-tao,ZHU Hong,HAN Yi-ting,MA Wei,ZHAO Qi-hui.Surgical treatment of tibia plateau fractures with external fixator and the locking plate[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(8):618~620
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