胫骨平台骨折与创伤性关节炎的防治

Treatment of tibia plateau fracture and traumatic arthritis

目的：解决胫骨平台骨折后及创伤性关节炎累及关面缺损的修复问题。方法：临床收治胫骨平台骨折５０例，对该类骨折除注重骨折良好复位，确实内固定外，对关节面缺损采取带蒂骨膜瓣翻转修复，对晚期创伤性关节炎作关节面成形修复。结果：经９～２４个月随访，关节间隙恢复，关节面平整，功能恢复满意。结论：取带蒂骨膜瓣翻转修复关节面缺损的成形术，可恢复平整的关节面，并使关节活动度增加。

Objective:To resolve the defect of the articulate suiface asulted from tibia plateau fracture or traumatic arthritisin the knee. Methods: 50 cases of tibia platean fracture had been treated in our department in the past six yeais. Accordingto the type of fracture and damage degree of articulate cartilap,42 of 50 cases were treated by suigical operation and foundthat all thase cases had different degree of articulate hyaline cartilage damage.Tibia fiacture with articulate surface injurywere treated not only by anatomic reduction and press internal fixation, bat also by the reduction and siut of dislocated artic-ulate surface. The loss of articular surface was repaired with pedicled tibia osteal transferring according to the damage degreeof eartilage. Results: After a follow-up of 3 to 5 years, low-gude or mild-grade traumatic arthritis occurred in only 6 of 42cases and sever late tmuniatic arthritis occurred in 3 cases.The late severe traumatic arthritis were repaired with the pedi-cled tibia esteal transferring with the resection of coteophyte and the restoration of joint space. After a follow-up of 6 to 24months, the joint space was restoied and the articular suiface was plat. Conclusion:The function of knee joint was restoredby this method. The motion range of the knee had an average increase of 30°. All the other cases had satidartory results.