复杂型胫骨平台骨折76例内固定手术疗效分析

To discuss the clinical therapeutic effect of the complicated style fractures of tibial plateau with internal fixation

目的:探讨复杂型胫骨平台骨折内固定手术治疗的临床疗效。方法:回顾性分析76例复杂型胫骨平台骨折患者,经切开复位并采用L型或T型加压钢板及高尔夫解剖钢板进行内固定手术的疗效。结果:76例骨折均愈合良好,经6月至6年随访,按Merchant评分标准评价,患者膝关节功能优24例、良32例、可12例、差8例,总优良率达73.68%,伤口一期愈合率89.47%,术后经积极膝关节功能锻炼后,膝关节伸屈功能90%以上得到恢复。结论:采用L型或T型加压钢板及高尔夫解剖钢板治疗SchatzkerⅣ型、Ⅴ型、Ⅵ型复杂型胫骨平台骨折,可以减少骨折的塌陷并达到关节面的解剖复位,其内固定牢固,经术后早期不负重膝关节适度功能锻炼,可取得较满意的疗效。

Objective：To discuss the clinical therapeutic effects of the complicated style fractures of tibial plateau with the open reduction and internal fixation.Methods：It analyzes the effects of 76 cases of complex style tibial fracture treated by open reduction and internal fixation with L-shaped compression plate,T-shaped compression plate and golf-shaped anatomic plate.Results：All of the 76 patients recovered very well based on the analysis of the findings of at least 6-month-period and at most 6-year-period follow up visits to the 76 cases,According to Merchant＇s evaluation criterion,the function of knee joint was excellent in 24 cases,good in 32,fair in 12 and poor in 8.The fineness ratio was about 73.68%.The rate of wound to heal by first intention was 89.47%.More than 90 percent of the patients who do the knee function exercise recovered from the knee joint flexure and extending function after operation.Conclusion：Treating the complicated fractures of tibial plateau of Schatzker Ⅳ、Ⅴ and Ⅵ types with the open reduction and internal fixation by implanting L-shaped compression plate,T-shaped compression plate and golf-shaped anatomic plate,can reduct collapse of fraction and reaches anatomical reduction and firmly fix the chips of fractures.It may get satisfactory curative effect by early postoperative and moderate articular genu functional exercises.