手术治疗胫骨平台骨折临床分析

Clinical Analysis of Open Surgical Treating the Fractures of Yibial Plateau

目的:探讨手术治疗胫骨平台骨折的临床分析。方法:对2009年6月～2010年6月开放手术治疗胫骨平台骨折23例进行回顾性分析,按照罗从风基于CT的胫骨平台骨折的三柱分型[1]:其中有4例单纯压缩骨折,11例单柱骨折,5例双柱骨折和3例三柱骨折。根据三柱分型选择手术入路及内固定方式,外侧柱、内侧柱和后侧柱骨折分别使用前外侧入路、改良正中入路和倒L形人路,对于双柱和三柱骨折则采取联合入路进行手术.术后随访评价临床效果。单纯压缩骨折3例,单柱骨折8例,双柱骨折3例,三柱骨折2例。结果:23例中16例得到随诊,经6～22个月的随诊,根据马元璋的评价标准[3]:优11例,良2例,可2例,差1例。结论:手术治疗胫骨平台骨折需选择好的术前分型,良好的解剖复位,坚强的内固定,积极早期处理合并伤,早期的膝关节功能锻炼。

Objective： To investigate clinical analysis of open surgical treatment the fractures of tibia1 plateau. Methods： From June 2009 to June 2010,23 cases of open surgical treatment the fractures of tibial plateau were analyzed retrospectively.According to Luo Cong Feng classification, 4cases were pure compression fractures, 11 cases one-column fractures, 5 cases tow-column fractures, 3 cases three-column fractures. Anterior-lateral, modified midline and reversed L-shaped approaches were used to treat lateral column, medial column and posterior column fractures respectively. Combined approaches were applied for double-column and three-column fractures. Results： 16 cases of 23 were followed for 6 to22 months.According the valuation standard ofMa Yuanzhang, llcases were excellent, 2 cases good, 2 cases acceptable, l cases worse.Conclusion： Open surgical treatment the fractures of tibial plateau need choose accurate preoperative classification,good anatomical repositioning, strong inside fixation, positive and early stage treatment of combination hurt, early function exercise of knee joint.