| SchatzkerⅡ型胫骨平台骨折的影像学评估及解剖钢板治疗 |
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Received:May 25, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王运涛 |
WANG Yun-tao |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
wangyttod @yahoo.com.cn |
| 吴小涛 |
WU Xiao-tao |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 陈辉 |
CHEN Hui |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 茅祖斌 |
MAO Zu-bin |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 王宸 |
WANG ChenKONG |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 孔翔飞 |
Xiang-fei |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 李永刚 |
LI Yong-gang |
东南大学附属中大医院骨科,江苏南京210009 |
Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu,China |
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| 期刊信息：《中国骨伤》2007年20卷，第11期，第732-735页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨SchatzkerⅡ型胫骨平台骨折术前充分影像学评估的重要性及解剖钢板治疗的临床疗效。
方法:SchatzkerⅡ型胫骨平台骨折患者67例,男48例,女19例;年龄16～69岁,平均45.4岁。开放性骨折10例,闭合性骨折57例。术前均行膝关节正、侧位X线摄片检查、螺旋CT薄层扫描和三维重建、MRI检查,根据影像学资料对患膝骨、软骨及软组织损伤进行评估。采用解剖钢板或结合关节镜进行治疗。
结果:X线片、CT、MRI在明确诊断方面没有明显差异,在分型诊断中,CT、MRI明显优于X线片;经MRI检查均存在不同程度的软骨损伤,常多种表现并存;CT、MRI检查发现伴随的软组织损伤分别为17例、59例;参考CT、MRI扫描后手术方式发生改变21例(31.3%)。术后随访9～31个月,平均18.2个月,骨折均获临床愈合;Rasmussen影像学及临床评分优良率分别为86.7%(58例)、94.0%(63例),Resnick-Niwayama分级评价呈现骨性关节炎的患者21例(31.3%)。未出现切口不愈合或感染,无膝内、外翻畸形,无钢板、螺钉断裂。
结论:结合X线片、CT、MRI能获得对手术方案制定及手术效果预测的重要图像信息;解剖钢板或结合关节镜治疗SchatzkerⅡ型胫骨平台骨折安全可靠、损伤小且疗效满意。 |
| [关键词]:胫骨骨折 影像学 骨折固定术 内 |
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| Radiographic assessment and treatment with anatomic plate in Schatzker Ⅱ tibial plateau fractures |
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Abstract:
Objective:To discuss the significance of radiographic assessment and the clinical results of treatment with anatomic plate in Schatzker Ⅱ tibial plateau fractures.
Methods:Sixty-seven patients with Schatzker Ⅱ tibial plateau fractures were examined by plain radiography and spiral CT and MRI.There were 48 males and 19 females with an average age of 45.4 years(ranged 16-69 years).There were 10 open fractures and 57 close fractures.All patients received plain radiography of anterior and lateral position of knee joint,and spiral CT scaning and MR imaging.The severity of injury to bone and articular cartilage and soft-tissue were evaluated by the radiographic data.All the patients were treated either anatomic plate alone or anatomic plate combined with arthroscopy.
Results:There was no significant difference in diagnosis among plain radiography and spiral CT and MRI.For classifying fractures,spiral CT and MRI was obviously superior to plain radiography.The injury to articular cartilage was only detected by MRI,which also detected 59 soft-tissue injuries.CT only detected 17 soft-tissue injuries.The initial operation plan was changed for 21 fractures(31.3%).All the patients were followed up for 9 to 31 months(18.2 months on average).Union was achieved in all 67 cases.The Rasmussen radiologic and clinical scoring systems,acceptable results is 86.7% and 94.0% of patients respectively.According to Resnick-Niwayama grading systems,the progression of osteoarthrosis by one grade or more occurred in 31.3% of patients.
Conclusion:CT and MRI combined with plain radiography is effective in the diagnosis of Schatzker Ⅱ tibial plateau fractures,providing better surgical planning and management and prediction.The anatomic plate combined with arthroscopy can obtain satisfactory results for Schatzker Ⅱ tibial plateau fractures,with reliable fixation and safety. |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王运涛,吴小涛,陈辉,茅祖斌,王宸,孔翔飞,李永刚.SchatzkerⅡ型胫骨平台骨折的影像学评估及解剖钢板治疗[J].中国骨伤,2007,20(11):732~735 |
| 英文格式: | WANG Yun-tao,WU Xiao-tao,CHEN Hui,MAO Zu-bin,WANG ChenKONG,Xiang-fei,LI Yong-gang.Radiographic assessment and treatment with anatomic plate in Schatzker Ⅱ tibial plateau fractures[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(11):732~735 |
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