内外侧锁定加压接骨板结合下肢力线的测量和恢复在胫骨近端C型骨折治疗中的应用

AO Locking Compression Plate with Preoperative, Intraoperative Line of Force of the Contralateral Lower Limb Measurement and Recovery in the C-Type Fractures of the Proximal Tibia

目的 探索一种简便且切实有效的手术模式治疗胫骨近端C型骨折.方法 选取2006年6月～2009年2月胫骨近端C型骨折住院病例共16例,均采用双切口入路,术前以软尺测量健侧下肢力线,术中消毒软尺测量患肢下肢力线,明确原因后术中立即进行纠正,得到良好的下肢力线,同时内固定器材选用AO锁定加压接骨板进行固定,术后指导功能锻炼.根据主诉,膝关节外观,膝关节功能及术前、术后X线征象评估治疗效果.结果 本治疗组所有病例全部得以随访,随访时间为术后10～15个月,平均12个月,骨折均达到临床愈合,膝关节功能根据美国HSS评分标准,优良率87.5%.结论 对于胫骨近端C型骨折的患者行双切口入路,内外侧锁定加压接骨板固定,结合术前、术中对下肢力线的测量与恢复,积极指导术后膝关节的功能锻炼,可以得到满意的疗效.

Objective To explore a simple and effective mode of surgical treatment of C-type fractures of the proximal tibia. Methods From June 2006 to February 2009,16 cases of type C fractures of the proximal tibia were adopted double-incision. The preoperative line of force of contralateral lower limb were measured by a soft tape. The intraoperative line of force of ipsilatera lower limb was measared by a disinfection soft tape, and corrected immediately to get a good line of force of lower limb, and fixed by AO locking compression plate, guided postoperative functional exercise. According to chief complaint, knee joint appearance, knee function and preoperative and postoperative X-ray findings to assess therapeutic effect. Results All 16 cases were available at follow up with mean duration of 12 months（10 - 15months）. All caseswere reached the clinical fracture healing, According to the US standard HSS score, The total percentage of good to excellent clinical result was 87.5 %. Conclusion Adopted double-incision and AO locking compression plate and adjusted line of force of lower limb and guided actively the postoperative knee functional exercise, the patients of C-type fractures of the proximal tibia can get satisfactory results.