LISS钢板固定Schatzker Ⅵ型胫骨平台骨折疗效分析

The analysis of surgical treatment of Schatzker Ⅵ tibial plateau fractures with LISS plate

目的探讨LISS钢板治疗SchatzkerⅥ型胫骨平台的疗效及操作技巧。方法对58例SchatzkerⅥ型胫骨平台骨折患者采用LISS钢板进行固定。记录并分析术后膝关节功能恢复情况、术后并发症情况。结果患者均获随访,时间15～27个月,骨折临床愈合时间为10～17周,87.9%的患者(51/58)在术后4周内膝关节活动范围恢复达120°。术后1年膝关节功能评定参照膝关节外科临床评分系统,优良率达到93.1%(54/58),疗效良好。1例发生远端锁定螺钉位于骨皮质外;1例出现外侧平台后部骨折块再移位;1例出现切口延迟愈合。无感染及骨折不愈合。结论采用LISS钢板固定SchatzkerⅥ型胫骨平台骨折,是一种有效的微创方法。正确安放钢板位置和恢复关节面平整是获得良好疗效的关键。

Objective To explore the clinical value of surgical treatment of Sehatzker VI tibial plateau fractures with LISS plate and the intraoperative skills. Methods 58 patients involved with tibial plateau fractures were fixed with LISS plate. The data about the recovery of knee function and complication were documented and analyzed. Results All the patients were followed up for 15 - 27 months. The time for bone union was 10 - 17 weeks. The range of motion was more than 120 degrees within 4 weeks postoperative in 87.9% of the patients（51/58）. The knee function was assessed according to the Knee Surgery Clinical Scoring System, the rate of excellent and good was 93.1% （54/58）. There was one case of malposition of the locking screw. One case of the lateral platform fractures appeared to shift; One case appear cut delay healing. There was no infection and nonunion. Conclusions The application of LISS plate in the treatment of Schatzker VI tibial plateau fractures is an effective minimal invasive surgery. The key points to ensure good results include recovery of smooth articular surface and right place of the plate.