| 微创内固定系统在高能量胫骨平台骨折中的应用 |
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Received:September 20, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 朱让腾 |
ZHU Rang-teng |
台州医院路桥院区骨科,浙江台州318050 |
Department of Orthopaedic,the Luqiao Branch of Taizhou Hospital,Taizhou 318050,Zhejiang,China |
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| 王建伟 |
WANG Jian-wei |
上海市第六人民医院骨科 |
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| 应有荣 |
YING You-rong |
台州医院路桥院区骨科,浙江台州318050 |
Department of Orthopaedic,the Luqiao Branch of Taizhou Hospital,Taizhou 318050,Zhejiang,China |
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| 眭述平 |
SUI Shu-ping |
上海市第六人民医院骨科 |
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| 朱轶 |
ZHU Yi |
江西医学院 |
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| 期刊信息：《中国骨伤》2006年19卷，第4期，第230-232页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨微创内固定系统治疗高能量胫骨平台骨折的方法和临床疗效。
方法:本组27例,男19例,女8例;年龄21~59岁,平均36岁;其中左侧12例,右侧15例。按Schatzker分型:Ⅴ型9例,Ⅵ型18例。其中合并前交叉韧带撕脱骨折3例,后交叉韧带断裂2例,半月板损伤3例。用改良内外侧联合切口,行微创内固定系统结合有限接触加压钢板（LC-DCP）内固定,其中3例半月板损伤,2例给予修补,另1例部分切除;3例前交叉韧带撕脱骨折给予钢丝固定;2例后交叉韧带断裂行Ⅱ期手术。术后2周、1、3、6个月、1年随访,行摄片及关节活动度检查,测定胫骨平台内翻角（TPA）及后倾角（PA）;术后1年行膝关节HSS评分。
结果:术后与术后1年TPA及PA平均值的差异无显著性统计学意义（TPA:t=1.012,P=0.356;PA:t=0.667,P=0.521）。术后1年膝关节HSS评分平均为86.9分（56~98分）,根据此评分标准:优15例,良7例,中4例,差1例。
结论:微创钢板治疗高能量胫骨平台骨折是理想、有效的方法,它具有手术创伤小、并发症少,骨折愈合率高,长期稳定性良好,膝关节功能恢复满意等优点。 |
| [关键词]:胫骨平台骨折 韧带损伤 半月板损伤 骨折固定术,内 |
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| "Minimally invasive surgery"steel plate for high energy fracture of tibial plateau |
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Abstract:
Objective:To explore the clinical effect of "Minimally invasive surgery"steel plate in the treatment of high energy fracture of tibial plateau.
Methods:A prospective study was conducted to analyze 27 cases of high energy fracture of tibial plateau who had been treated with internal fixation of "Minimally invasive surgery"steel plate and LC-DCP.Their age was 21-59 years with an average of 36 years.Among them,male 19 and female 8;left 12 and right 15.According to classification of Schatzker:9 cases were type Ⅴ,18 cases were type Ⅵ.3 cases combined with avulsion of anterior cruciate lig(fixed with wire),2 cases combined with disruption of posterior cruciate lig(operation in the second period),3 cases had meniscus injury(2 were repaired,1 was cut partly).An anterior-lateral approach combined with a small posterior-medial approach was used to reduce the risk of soft tissue complication.The fractures were fixed with "Minimally invasive surgery"steel plate and LC-DCP.All the patients were followed up in 2 weeks,1,3,6 months and 1 year after operation.Tibial plateau angle(TPA)and posterior slope angle(PA)of tibial plateau were measured to evaluate the stability of proximal tibia and knee alignment.The function of knee joint were evaluated according to criterion of HSS.
Results:The mean value of tibial plateau angle(TPA)and tibial plateau posterior slope angle(PA)had no significant difference in one year after operation(TPA:t=1.012,P=0.356;PA:t=0.667,P=0.521).The mean HSS score was 86.9(56-98)points in one year after operation.According to criterion of HSS:15 cases obstained excellent results,7 good,4 fair and 1 poor.The total satisfactory rate was 81.5%.
Conclusion:"Minimally invasive surgery"steel plate is an effective method for high energy fracture of tibial plateau,which has the advantages of minimal trauma,less complication,high healing rate,reliable fixation and long-term stability. |
| KEYWORDS:Tibial plateau fracture Injury of ligament Meniscus injury Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱让腾,王建伟,应有荣,眭述平,朱轶.微创内固定系统在高能量胫骨平台骨折中的应用[J].中国骨伤,2006,19(4):230~232 |
| 英文格式: | ZHU Rang-teng,WANG Jian-wei,YING You-rong,SUI Shu-ping,ZHU Yi."Minimally invasive surgery"steel plate for high energy fracture of tibial plateau[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(4):230~232 |
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