胫骨平台后髁骨折的手术治疗

Surgical treatment of posterior condyle fracture of tibial plateau

目的:探讨累及后髁的胫骨平台骨折的手术治疗方法.方法:选取9例累及胫骨平台后髁的骨折患者,3柱骨折及内侧柱合并后侧柱骨折患者采用后外侧及后内侧入路,必要时加用前外侧入路;外侧柱合并后侧柱骨折患者采用前外侧入路及后内侧入路或后外侧入路.显露折端,撬起关节面,植骨,以钢板固定支撑.结果:所有患者骨折在3-7个月愈合,平均愈合时间5.1个月.X片显示骨折均I期愈合.Lysholm膝关节功能评分,术前与术后相比,P<0.01,差异有显著统计学意义.结论:采用双切口及后侧支撑钢板治疗累及后侧髁的胫骨平台骨折,能有效恢复胫骨平台关节面的平滑及下肢力线,骨折愈合良好.

Objective:To study the surgical treatment of tibial plateau involving fracture posterior condyle.Methods:Selected 9 cases of fracture involving the posterior condyle of the tibia platform.Patients with three-post fracture and medial column combined with posterior lateral column fracture use posterior lateral and posterior medial approach,plus anterior lateral approach if necessary.Patients with posterior lateral column fracture with lateral column use anterior lateral approach and posterior medial approach or posterior lateral approach.Expose the fracture,pry up the joint surface,graft the bone,fix and support with steel plate.Results:All fractures healed in 3 to 7 months,with an average healing time of 5.1 months.X Ray shows all the fractures healed in phase I.According to Lysholm knee function score,the difference between preoperative and postoperative was statistically significant(P<0.01).Conclusion:The treatment of tibial plateau fractures involving posterior condyle with double incision and posterior support plate could effectively restore the smooth joint surface of tibia platform and lower extremity force lines,and the fracture healing was good.