联合切口双钢板植骨治疗复杂胫骨平台骨折62例疗效分析

Assessment of treatment of complex tibial plateau fracture with bilateral steel plate fixation and bone graft

目的:探讨双侧钢板内固定治疗复杂胫骨平台骨折的临床效果。方法:回顾性分析我院1998～2007年采用双侧钢板内固定加植骨治疗复杂胫骨平台骨折62例患者的临床资料,术中用双钢板固定,内侧采用小钢板,外侧如用加长钢板则潜行分离插入,通过皮肤小切口螺钉固定以减少皮瓣的长度和剥离面,同时术中充分植骨对关节面的复位起有效的支托作用,术后早期膝关节屈伸功能锻炼。结果:所有病例无膝关节内外翻现象,3例(5%)术后轻度胫骨平台再次塌陷,2例出现伤口感染皮瓣坏死,优良率达95%。结论:双侧钢板治疗复杂胫骨平台骨折是有效的方法,术中充分植骨,术后引流通畅和早期功能锻炼,可减少并发症,明显提高疗效。

Objective： To investigate the clinical effect of treatment of complex tibial plateau fracture with bilateral steel plate fixation and bone graft. Methods： Clinical data of 66 patients with complex tibial plateau fracture treated using bilateral steel plate fixation and bone graft from 1998 to 2007 were studied retrospectively. The fractures were fixed with a small steel plate at internal side and a long steel plate at external side inserted without incision of the outside soft tissure and fixed by screw through a tiny incision of skin, at the same time, bones were grafted to sure the stability of reduction; postoperative functional exercise of knee was conducted early. Resuits： No varus and valgus occurred, 3 patients （5%） had mild collapse of the tibial plateau, two patients had wound infection and skin flap necrosis, the very good and good rate was 95%. Conclusion： Treatment of complex tibial plateau fracture with bilateral steel plate fixation and bone grafting has good effect and less complication.