| 胫骨平台骨折手术治疗疗效分析 |
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Received:August 19, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 汪仁焕 |
WANG Ren-huan |
萧山第二人民医院骨科,,浙江杭州311241 |
The 2nd People’s Hospital of Xiaoshan,Hangzhou 311241,Zhejiang,China |
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| 欧志根 |
OU Zhi-gen |
萧山第二人民医院骨科,,浙江杭州311241 |
The 2nd People’s Hospital of Xiaoshan,Hangzhou 311241,Zhejiang,China |
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| 孙海峰 |
SUN Hai-feng |
萧山第二人民医院骨科,,浙江杭州311241 |
The 2nd People’s Hospital of Xiaoshan,Hangzhou 311241,Zhejiang,China |
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| 期刊信息：《中国骨伤》2006年19卷，第3期，第152-154页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨胫骨平台骨折手术治疗的临床效果。
方法:手术治疗胫骨平台骨折26例,根据骨折类型、主要骨折块与塌陷部位选择切口,术中采用“T”形、“L”形或曲棍球棒形支撑钢板固定,骨折压缩部位复位后的骨缺损应用髂骨或人工骨植骨,同时分析术后外固定和屈膝功能锻炼时间对膝关节功能恢复的影响。
结果:本组26例随访6个月~4年,采用Rasmussen评分标准评定临床疗效,结果优7例,良16例,可2例,差1例,优良率88.5%。术后2周内作屈膝功能锻炼者膝关节伸屈功能22例中20例恢复正常,外固定6周后再作膝功能锻炼4例中1例出现膝关节伸屈活动度减小。
结论:胫骨平台骨折的手术治疗按骨折类型而定,其疗效取决于关节面平整、下肢力线和关节韧带骨组织连续性的恢复,骨折压缩部位复位后骨缺损必须植骨、有效固定、适时早期功能锻炼。 |
| [关键词]:胫骨骨折 骨科手术方法 骨折固定术 骨移植 |
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| Analysis of therapeutic effects of surgical treatment for tibial plateau fractures |
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Abstract:
Objective:To explore the therapeutic effects of surgical treatment for tibial plateau fracture.
Methods:From June 2000 to August 2004,26 patients with tibial plateau fractures were treated with operation.Among them,16 patients were male and 10 were female,with ages from 23 to 61 years,averagely 42.3 years.According to Schatzkers classification,the fracture were diagnosed as Type Ⅰ in 3,Type Ⅱ in 7,Type Ⅲ in 8,Type Ⅳ in 4,Type Ⅴ in 3,Type Ⅵ in 1.Approaches were selected based on the classification and the site of large fragment and depressed point of articular surface.T-shape,L-shape or hockey stick shape supporting plate were used to be internal fixation.If there were bone defects after reduction,iliac or artificial bone grafting were performed.The effects of external fixation after operation and exercise time of knees flexure and extending on the function recovery of knee joint were analysed.
Results:All the patients were followed up from 6 months to 4 years,with an average of(22.3±16.5)months.All fractures were united within 12 weeks after operation.According to Rasmussens 30-point knee rating system,7 patients obtained excellent results,16 good,2 fair and 1 poor.The excellent-and-good rate was 88.5%.Among 22 patients who do exercises from 2 weeks after operation,20 recovered to normal.Within 4 patients who do exercises from 6 weeks after operation,1 had activity limitation of knee joint.
Conclusion:Operative methods for the treatment of tibial plateau fracture should be selected according to fracture classification.Following factors can ensure to gain good therapeutic effects:excellent restoration of articular surface and mechanical axis;recovery of continuous of articular ligament and bone;bone grafting to the defect points after reduction;effective fixation and early exercises of knee joint. |
| KEYWORDS:Tibial fractures Orthopaedics operative methods Fracture fixation Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 汪仁焕,欧志根,孙海峰.胫骨平台骨折手术治疗疗效分析[J].中国骨伤,2006,19(3):152~154 |
| 英文格式: | WANG Ren-huan,OU Zhi-gen,SUN Hai-feng.Analysis of therapeutic effects of surgical treatment for tibial plateau fractures[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(3):152~154 |
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