| 扩展的前外侧入路治疗胫骨平台后外侧骨折 |
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投稿时间：2016-03-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈红卫 |
CHEN Hong-wei |
温州医科大学附属义乌医院骨科, 浙江 义乌 322000 |
Department of Orthopaedic Surgery, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Yiwu 322000, Zhejiang, China |
chw6988@aliyun.com |
| 王子阳 |
WANG Zi-yang |
温州医科大学附属义乌医院骨科, 浙江 义乌 322000 |
Department of Orthopaedic Surgery, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Yiwu 322000, Zhejiang, China |
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| 李军 |
LI Jun |
温州医科大学附属义乌医院骨科, 浙江 义乌 322000 |
Department of Orthopaedic Surgery, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Yiwu 322000, Zhejiang, China |
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| 赵胜春 |
and ZHAO Sheng-chun |
温州医科大学附属义乌医院骨科, 浙江 义乌 322000 |
Department of Orthopaedic Surgery, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Yiwu 322000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第8期，第752-755页 |
| DOI：10.3969/j.issn.1003-0034.2016.08.015 |
| 基金项目:义乌市科技攻关计划项目（编号：2009-G3-02） |
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| 中文摘要:目的：探讨扩展的前外侧入路治疗胫骨平台后外侧骨折的方法和临床疗效。方法：2011年1月至2013年12月，采用扩展的前外侧入路治疗胫骨平台后外侧骨折15例，男9例，女6例；年龄23～70岁，平均（38.4±7.7）岁。左膝7例，右膝8例。致伤原因：车祸伤6例，高处坠落伤7例，平地跌倒伤2例。受伤至手术时间2～14 d，平均5.6 d.结果：所有患者获随访，时间12～30个月，平均 19.7个月。术后行膝关节正侧位X线片和CT扫描示14例解剖复位，1例有3 mm的台阶。骨折愈合时间8～14周，平均9.6周。无伤口并发症、骨不愈合、钢板松动或断裂、膝关节外翻畸形和骨折再移位，无腓总神经和血管损伤。在最终的随访时，膝关节伸直（2.1±2.1）° 和屈曲（120.6±18.9）°。膝关节Rasmussen功能总评分25.0±2.8，优10例，良4例，可1例。结论：扩展的前外侧入路可充分显露胫骨平台后外侧骨折块，有利于复位，与传统的前外侧入路相比可更安全有效地偏后放置外侧支撑钢板。 |
| 【关键词】胫骨平台骨折 骨折固定术,内 前外侧入路 |
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| Treatment of posterolateral tibial plateau fractures through an extended anterolateral approach |
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| ABSTRACT Objective: To study the methods and therapeutic effects of posterolateral tibial plateau fractures with an extended anterolateral approach. Methods: From January 2011 to December 2013,15 patients with posterolateral tibial plateau fractures were treated by extended anterolateral approach,including 9 males and 6 females,with an average age of (38.4±7.7) years old ranging from 23 to 70 years old. Seven patients were on the left knees and 8 patients were on the right knees. The injury causes included traffic accidents in 6 cases,falling from height in 7 cases,and falling down when walking in 2 cases. The time from injury to operation was 2 to 14 days(means 5.6 days). Results: All patients were followed up with an average of 19.7 months ranging from 12 to 30 months. All patients were followed with anteroposterior and lateral X-ray and CT films,which showed anatomic reduction or near-anatomic reduction. The follow-up CT scan showed an anatomic reduction in 14 patients and step and gap measurement of 3 mm in 1 case. The average radiographic bony union time was 9.6 weeks (ranged from 8 to 14 weeks). There were no wound complications,nonunion,plate loosening or breakage,valgus knee deformity,or fracture redisplacement. No patients sustained neural or vascular injuries,with knee extension of (2.1±2.1)° and knee flexion of (120.6±18.9)° at the final follow-up. The total Rasmussen score averaged (25.0±2.8) points,the result was excellent in 10 cases,good in 4 cases,fair in 1 case. Conclusion: The extended anterolateral approach has the advantage of allowing visualization of the posterolateral tibial plateau fragments,therefore facilitating its reduction. The approach also ensures safe and adequate posterior placement of a lateral buttress plate because the plate can be placed more posteriorly than can occur through an anterolateral approach. |
| KEY WORDS Tibial plateau fractures Fracture fixation,internal Anterolateral approach |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈红卫,王子阳,李军,赵胜春.扩展的前外侧入路治疗胫骨平台后外侧骨折[J].中国骨伤,2016,29(8):752~755 |
| 英文格式: | CHEN Hong-wei,WANG Zi-yang,LI Jun,and ZHAO Sheng-chun.Treatment of posterolateral tibial plateau fractures through an extended anterolateral approach[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(8):752~755 |
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