双钢板治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折

Treatment of tibial plateau fractures of Schatzker types Ⅴ and Ⅵ with double plates

目的探讨双钢板治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折疗效。方法采用双钢板治疗15例SchatzkerⅤ、Ⅵ胫骨平台骨折患者,术后第1天即进行膝关节功能锻炼。结果患者经过6-38个月随访,术后伤口一期愈合,无骨折延迟、畸形愈合。X线片显示胫骨平台均未发生二期塌陷,膝关节屈曲120°-135°。膝关节功能采用Iowa膝关节评分标准评定：优10例,良4例,可1例。结论采用双钢板治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折,术中注意避免对胫前皮瓣和骨折端血供的过分破坏、固定可靠及术后及时正确功能锻炼是取得良好疗效的关键。

Objective To evaluate the clinical effects of treatment of tibial plateau fractures of Schatzker types Ⅴ and Ⅵ with double plates. Methods 15 cases of Schatzker types Ⅴ and Ⅵ tibial plateau fractures were treated by double plates internal fixation. There were 9 cases of SchatzkerV ,6 type VI. Results All the patients were followed up for 6 - 38 months with average of 20. 5 months. There was no delayed union or malunion in all the cases. According to the postoperative X-ray examination, there was no collapse of the tibial plateau. The flexion range of knee got 126.5°（ 120°- 135°） . According to Iowa evaluation system, 10 patients had excellent resuhs,4 good and 1 fair,and the excellent and good rate was 93.3% - Conclusions For the treatment of tibial plateau fractures of Schatzker types V and VI with double plates, avoiding damage the blood supply to the pre-tibial skin flap and the fracture ends, reliable fixation and correct postoperative functional exercises in time are keys to obtain a satisfactory therapeutic effect.