高能量胫骨平台骨折的手术治疗

Surgical treatment of high-energy of tibial plateau fractures

目的探讨高能量损伤胫骨平台骨折手术治疗效果。方法从1995年8月至2004年7月收治高能量胫骨平台骨折患者32例。骨折按Schatzker分型:Ⅳ型骨折10例,Ⅴ型骨折14例,Ⅵ型骨折8例。采用切开复位内固定治疗,骨缺损者同时予以植骨。结果经6～24个月随访,平均13个月。32例均全部愈合。按Hiss膝关节临床功能评分[1]为78.6分。结论胫骨平台高能量胫骨平台骨折宜手术治疗,但必须着重于选择手术时机、坚强的内固定,尽量维持正常的力轴线,确保关节稳定,早期积极处理合并伤,早期的膝关节功能锻练。

Objective To discuss the results of operative treatment of high-energy injury of tibial plateau fracture. Methods From August 1995 to July 2004,32 cases of high-energy of tibial plateau fracture were analyzed retrospectively,According to SchatAker type 10 eases type Ⅳ. 14 eases type Ⅴ. 8 cases type Ⅵ. They were treated with open reduction and interal fixation with butterss plates and allograft implantion for defective fractures. Results The follow up observation lasted from 6 to 24 months,an average of 13 months,all the frac- ture healed, According to Hiss＇ s I1]criteria for clinical evaluation of knee joint score of 78. 6. Conclusion The high-energy fracture of tibial plateau should betreated sur-gically, but it need choose opportunity of operation, strong inside fixation, positive and early stage treatment of combination hurt, early function acquired training of knee joint.