前后联合入路双钢板固定治疗复杂胫骨平台骨折

Anterior and posterior approaches for treatment of complex tibial plateau fracture with double-plating fixation

目的探讨前后联合入路双钢板固定治疗复杂胫骨平台骨折的效果。方法应用前后联合入路、前外侧和后内侧钢板联合固定治疗24例复杂胫骨平台骨折。结果 24例均获随访,时间12~24（13.6±3.04）个月。骨折均获愈合,时间为3~4.5（3.3±0.6）个月。术后即刻X线片示23例解剖复位,1例复位不完全。术后1.5、3、6、12个月X线片与术后即刻X线片对比无变化。术后3个月开始负重,完全负重时间4~5（4.4±0.3）个月。术后12个月膝关节屈曲85~135（124±10.9）,°伸膝为-3~5（1.8±2.1）°。术后12个月膝关节Aks评分为64~94（87.5±6.9）分。切口无感染和裂开,内固定无松动及断裂。结论前后联合入路双钢板固定治疗复杂胫骨平台骨折效果满意。

Objective To investigate the surgical outcome of anterior and posterior approach for treatment of complex tibial plateau fracture with double-plating fixation.Methods 24 cases of complex tibial plateau fractures were treated by double-plating internal fixation by anterior and posterior approach,anterolateral approach and posteromedial approach.Results 24 cases were followed up for 12~24（13.6±3.04） months.Bone union was achieved in all cases,and the time was 3~4.5（3.3±0.6） months.Postoperative instantly X-ray displayed that there were 23 cases with anatomic reduction,and 1 case with unsatisfactory reduction.No X-ray change in one and a half month,3 months,6 months and 1 year after operation was found compared with postoperative instantly X-ray.Weight-bearing was practiced 3 months after operation.The time to full weight-bearing was 4~5 months（4.4±0.3） months.The flexion range of motion was 85~135（124±10.9）°,and the extension was-3~5（1.8±2.1）° 1 year after operation.1 year postoperative Aks was 64~94（87.5±6.9）.There was no incision infection and rupture,loosening and breakage of fixation.Conclusions The double-plating operation by anterior and posterior approach is an effective way of treating complex tibial plateau fractures.