经后侧入路支持钢板固定治疗胫骨平台后侧骨折

Posterior shearing fractures of tibial plateau treated with buttress plates via a posterior approach

目的探讨经膝关节后侧入路支持钢板固定治疗单纯胫骨平台后侧骨折的临床效果。方法对16例单纯胫骨平台后侧骨折患者经膝关节后侧切口暴露骨折后直视下复位,支持钢板固定。术后对患者骨折愈合情况、功能恢复程度和治疗结果满意度定期随访。结果 16例均获得随访,时间12～24个月。术后1年时行Rasmussen膝关节功能评分:优10例,良4例,中2例。结论膝关节后侧入路能够充分暴露单纯胫骨平台后侧骨折,骨折容易达到解剖复位,支持钢板固定稳定可靠,但术中要熟悉腘窝区解剖结构。正确掌握手术适应证,可获得良好的临床疗效。

Objective To study the outcome of posterior shearing fractures of tibial plateau with buttress plates via a posterior approach. Methods 16 patients with single posterior shearing fractures of tibial plateau were operated via a posterior approach and followed up retrospectively. The progress of fracture healing and radiographs were recorded. Results All patients were followed up for 12 -24 months. According to Rasmussen knee function score system at 1 year post operation, there were 10 excellent cases, 4 good and 2 fair. Conclusions Even though familiar understanding of the popliteal fossa anatomy is required, a posterior approach can provide sufficient space for exposing and reducing single posterior fractures of tibial plateau, while a buttress plate has stable fixation for the fragments.