复杂胫骨平台骨折的手术治疗

Surgical treatment of the complex fractures of the tibial plateau

目的:探讨复杂性胫骨平台骨折的手术治疗方法和疗效,为临床选择更好的治疗复杂性胫骨平台骨折的方法。方法:自1994-2001年收治胫骨平台骨折116例,按照Schatzker分型复杂胫骨平台骨折37例,男31例,女6例。均经切开复位,严格按照内固定原则分别采用螺丝钉、钢板或外固定架固定进行骨折治疗。结果:37例均得到随访,最短19个月,最长7年,平均23个月。骨折均愈合,疗效评定参照Merchant标准,术后6个月优良率为83.8%,术后1年优良率为89.2%。结论:复杂性胫骨平台骨折应当考虑手术治疗,术中必须早期处理受损的软组织;内固定物的选择应当灵活掌握。

Objective: To discuss therapeutic effect and methods for the treatment of the complex fracture of tibial plateau and choose a better method for clinical application.Methods:Thirty-seven patients (male 31 cases,female 6 cases) with complex fractures of the tibial plateau of 116 patients were treated from 1994 to 2001.According to standard of Schatzker's classification,19 patients were in type Ⅳ,5 type Ⅴ,and 13 type Ⅵ.Based on principles of internal fixation,the patients were performed screw,plate internal fixation or external fixation respectively.Results:The patients were followed-up for an average of 23 months from 19 months to 7 years.The fractures were healed.The evaluation of knee joint functional recovery was based on Merchant standard.Among 37 patients,the excellent and good rates of the recovery of knee joint function were 83.8% and 89.2% in 6 months and 1 year after the operation.Conclusion:It is highly recommended the application of open reduction and internal fixation for the treatment of comlex fractures of the tibial plateau.Early treatment of soft tissuse injuriy is necessary.The choose of the internal fixation instrument appliance should be active.