胫骨平台骨折合并软组织损伤的临床分析与治疗

Clinical analysis and treatment of tibial plateau fractures combined with injury of soft tissue

目的:总结分析各种胫骨平台骨折合并不同类型软组织损伤中的相互关系,探索其诊断与治疗策略。方法:自1995年10月至2004年1月共治疗胫骨平台骨折合并软组织损伤143例。所有病例均行开放复位内固定,对不同类型软组织损伤同时采取相应的处理方法。结果:术后随访129例,随访时间6到27个月,平均16个月;骨折均于12周内愈合,所有患者均恢复了患肢的正常力线,患肢稳定。结论:胫骨平台骨折合并软组织损伤的诊断必须早期、全面、详细、明确,坚强的内固定基础上,对不同类型的软组织损伤必须正确处理,术后应注意被动伸膝及CPM功能锻炼,这样才能最大程度挽救膝关节功能,减少晚期并发症。

Objective：To study the relationship between six types of tibial plateau fractures and different kinds of soft tissue injury ,explore the tactics of the diagnosis and treatment. Methods： From October 1995 to January 2004,143 patients with tibial plateau fractures combined with soft tissue injury were treated in our hospital. All the fracture fragments of tibial plateau were reduced with open manipulation and fixed by T-buttress plate and cannulated screws ,according to the different kind of soft tissure injury. Results： 143 patients, 129 were followed up from 6 to 27 months （average, 16months）. All the fractures except one case which was under amputation of leg were united within 12 weeks post operatively. Conclusions：The diagnosis of tibial plateau fracture associated with soft tissue injury should be obtained early, complete. Detailed and definitely. Based on firm internal fixation , correct management of soft tissue injury is necessary. Passive extension of knee joint and CPM exercise must be considered to rescue the function of knee joint and reduce late complication.