胫骨平台后髁骨折的治疗

Treatment of posterior condylar tibial plateau fracture

目的：探讨胫骨平台后髁骨折的治疗方法.方法：9例胫骨平台后髁骨折患者,男6例,女3例;年龄24～58岁,平均36岁.左侧2例,右侧7例.骨折类型：后外侧髁骨折5例,后内侧髁骨折1例,双髁骨折3例,采用后内和（或）后外侧入路复位内固定治疗.结果：9例均获随访,随访时间6～32个月,平均18.4个月.患膝关节功能评定按Hohl评分标准：优7例,良2例.关节面未见明显塌陷情况.结论：膝关节的后内和（或）外侧入路较前侧入路能更充分暴露后关节间隙及胫骨平台后髁,为骨折的直视复位和植骨内固定提供了良好的操作空间.

Objective：To study the operative method of posterior medial and （or） lateral approach for the treatment of posterior condylar tibial plateau fracture. Methods： Nine patients with posterior condylar tibial plateau fracture were treated with open reduction and internal fixation through posterior medial and （or） lateral approach. There were 6 males and 3 females with the average age of 36 ranging from 24 to 58 years old. There were 5 cases of lateral condyle fractures, 1 cases of medial condyle fracture and 3 cases of bilateral. Results：All patients were followed up for 6 - 32 months with average of 18.4 months. According to Hohl score of the knee joint function,7 cases were excellent result and 2 cases were good. No joint surface collapse was found. Conclusion：The posterior medial and （or） lateral approach can fully expose the posterior joint space and can provide satisfactory operative space for open reduction, grafting and internal fixation.