| 大块髂骨重建胫骨平台治疗胫骨髁劈裂塌陷骨折 |
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Received:December 24, 2004
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| 作者 | Author | 单位 | Unit | E-Mail |
| 彭国栋 |
PENG Guo-dong |
青岛市市立医院骨科,山东青岛266011 |
Department of Orthopeadics,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China |
pengguodong@medmail.com.cn |
| 林勇 |
LIN Yong |
青岛市市立医院骨科,山东青岛266011 |
Department of Orthopeadics,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China |
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| 张云飞 |
ZHANG Yun-fei |
海军401医院手外科 |
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| 历强 |
LI Qiang |
青岛市市立医院骨科,山东青岛266011 |
Department of Orthopeadics,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China |
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| 期刊信息：《中国骨伤》2005年18卷，第10期，第577-579页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨胫骨平台严重劈裂塌陷的手术方法。
方法:自1998年8月-2003年3月,采用大块髂骨重建胫骨平台治疗胫骨髁劈裂塌陷骨折31例,其中男24例,女7例;年龄24～62岁,平均36岁。根据Schatzker分类Ⅱ型劈裂塌陷型21例,Ⅲ型单纯中央塌陷型6例,Ⅳ型内髁骨折4例。将塌陷的关节面撬起复位至平整后取自体大块髂骨在其下方约1.0cm处水平插入,并在下方再用髂骨块垂直支撑,在关节面下重建坚实可靠的支持平台,然后用AO支持钢板支撑固定,术后石膏固定6周进行功能锻炼,12周后逐步下地负重。
结果:随访1～5年,根据Merchant标准综合分析优19例,良8例,中4例。
结论:利用大块髂骨关节面下支撑既可充填缺损,又可构筑可靠的支持平台,保证了关节面的平整和高度;AO支撑钢板固定牢固,有利于早期功能锻炼,防止关节僵硬,疗效满意。 |
| [关键词]:胫骨骨折 骨折固定术,内 骨移植 |
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| Treatment of severe splitting and compressive tibial plateau fractures by grafting large block of iliac bone to reconstruct tibial plateu |
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Abstract:
Objective:To investigate the surgical treatment on the severe splitting and compressive tibial plateau fractures.
Methods:From August,1998 to March,2003,thirty-one patients (24 male and 7 female,aged from 24 to 62 years with an average of 36) with severe splitting and compressive tibial plateau fractures were treated with large block of iliac bone graft to reconstruct tibial plateau and fixation with AO supportive plate.According to Schatzker classification,21 patients were type Ⅱ,6 type Ⅲ and 4 type Ⅳ.After elevating the collapsed articular surface,an appropriate size of iliac graft was inserted horizontally at 1.0 cm inferior to articular surface.Under the graft,another iliac graft was inserted perpendicularly to surpport it so as to reconstruct solid and reliable supporting plateau beneath the articular surface.AO supporting plate was used for fixation.Six weeks after fixation with plaster,functional training was practised and walking loading was not exerted until 12 weeks after fixation.
Results:All the patients were followed up from 1 to 5 years.According to the standards of Merchant,the curative effect was excellent in 19 patients,good in 8 and fair in 4.
Conclusion:Large block of iliac graft placed below the articular surface can not only fill the defect,but also insure the integrity and height of the articular surface and prevent re-collapsing.AO supportive plate provides rigid fixation so that patients can perform functional exercises earlier,which will prevent joint stiff,osteoporosis and reduce the incidence of arthritis. |
| KEYWORDS:Fracture of tibia Fracture fixation,internal Bone graft |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 彭国栋,林勇,张云飞,历强.大块髂骨重建胫骨平台治疗胫骨髁劈裂塌陷骨折[J].中国骨伤,2005,18(10):577~579 |
| 英文格式: | PENG Guo-dong,LIN Yong,ZHANG Yun-fei,LI Qiang.Treatment of severe splitting and compressive tibial plateau fractures by grafting large block of iliac bone to reconstruct tibial plateu[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(10):577~579 |
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