双切口双钢板治疗复杂胫骨平台骨折治疗体会

The Comprehension of Two-incision Double-plate for the Treatment of Complex Fracture of Tibial Plateau

目的探讨双切口双钢板治疗复杂胫骨平台骨折的临床效果。方法回顾性分析2002年2月至2008年5月采用双切口双钢板内固定加植骨治疗复杂胫骨平台骨折32例患者的临床资料。术中采用内外侧两个切口双钢板内固定,内侧采用小钢板,外侧如用加长钢板潜行分离插入,术中植骨。术后强调早期康复锻炼。结果32例均获随访,随访时间9～26个月,平均14个月,按雍氏评分标准评定,优17例,良11例,可3例,差1例,优良率87.5%。结论双切口双钢板治疗复杂胫骨平台骨折疗效满意。合适的手术时机和切口选择、解剖复位、植骨和可靠固定,以及术后正确的康复锻炼是提高复杂性胫骨平台骨折疗效的重要因素。

Objective To explore the clinical effect of the two-incision double-plate for the treatment of complex tibial plateau fracture. Methods Retrospective analysis in February 2002-May 2008 two-incision double-plate fixation plus bone graft treatment of complex tibial plateau fracture patients with 32 cases of clinical data. Intraoperative incision using two pairs of medial and lateral plate fixation, using a small plate inside, such as lengthening the lateral separation insert sneak plate, bone graft surgery. Emphasis on early rehabilitation after exercise. Results 32 cases were followed up for 9 to 26 months. The average period was 14 months. According to YONG Shi score system, the results were excellent in 17 cases, good in 11 cases, fair in 3 cases and poor in 1 case. The excellent and good rate was 87.5%. Conclusion Two-incision double-plate for the treatment of complex tibial plateau fractures with satisfaction. Appropriate choice of surgical time and incision, anatomic reduction, and reliable bone fixation, and postoperative rehabilitation exercise the right to increase the complexity of the tibial plateau fracture of the important factors.