经皮鱼嘴钳固定治疗胫骨平台骨折

Treatment of tibial plateau fracture with percutaneous fish-lip pincers fixation

目的：分析微创技术治疗胫骨平台骨折的疗效。方法：胫骨平台骨折83例，男59例，女24例；年龄18～58岁，平均37岁。交通事故伤36例，坠落伤21例，砸伤10例，摔伤16例。外翻应力伤31例，内翻应力伤9例，垂直压迫或合并旋转应力伤43例。按Schatzker分类：Ⅰ型15例，Ⅱ型26例，Ⅳ型17例，Ⅴ型25例。均行经皮撬拨复位、鱼嘴钳固定治疗。结果：随访81例，时间2～7年，骨折均于3个月内愈合，膝关节完全伸直，屈膝平均127°（95°～145°）。参照Rasmussen胫骨髁部骨折膝关节功能进行评分：优49例，良27例，可4例，差1例。结论：经皮鱼嘴钳固定手术创伤小，固定可靠，能早期进行功能锻炼，避免二次手术取内固定物，是治疗胫骨平台骨折的有效方法。

Objective： To analyze the effect of minimal invasive surgery for the treatment of tibial plateau fracture. Methods： Eighty-three patients （ male 59 and female 24, age ringing from 18 to 58 years with the mean of 37 ） with tibial plateau fracture were treated with percutaneous fish-lip pincers fixation. Thirty-one cases were injuried by valgus stress and 9 cases were varas stress ,43 cases injuried by vertical compression and shearing stress. According to standard of Schatzker, type Ⅰ in 15 ,type Ⅱ in 26 ,type Ⅳ in 17 ,and type Ⅴ in 25. The clinical data of the patient was analyzed. Results： Eighty-one patients were followed up from 2 to 7 years. All the fractures healed in 3 months after operation and all the knee joints can extend completely,the average genuflex was 127° （from 95° to 145°）. According to Rasmussen＇s functional recovery standard of knee joint,49 patients obtained excellent result,27 good,4 fair and 1 poor. Conclusion： Fish-lip pincer is a reliable fixer, it permits earlier exercise, lessens the operative injuries and avoids additional operation （ taking out internal fixer）. It is a handy and effective method for the treatment of tibial plateau fracture.