双接骨板内固定治疗胫骨平台骨折

Effects of the treatment of severe tibial plateau fracture with double plates

目的探讨双接骨板内固定治疗胫骨平台骨折的临床效果。方法应用双接骨板内固定治疗35例SchatzkerⅤ、Ⅵ型胫骨平台骨折患者,骨缺损者予以植骨。结果 35例均获随访,时间12～24个月,骨折均愈合。术后发生切口皮肤局部坏死或浅表感染6例,经伤口换药及对症处理后愈合。发生3 mm以内关节面塌陷4例。无骨不连、慢性骨髓炎及力线丢失发生;按照Hohl膝关节功能评分标准:优17例,良11例,可4例,差3例,优良率为80.0%。结论双接骨板内固定治疗胫骨平台骨折临床效果满意。

Objective To explore the effects of the treatment of severe tibial plateau fracture with double plates. Methods 35 cases with tibial plateau fracture of type Schatzker V,Ⅵ were treated by internal fixation with double plates. They were treated by open reduction, internal fixation and allograft implantation for defective fracture. Results All 35 cases were followed up for 12 ～ 24 months and all healed. The flap necrosis happened in 6 cases, and they achieved incision healing basing on the allopathy. The collapse in articular surface happened in 4 cases and no more than 3mm. No complications had happened such as nonunion, osteomyelitis, and loss in alignment in all cases. The outcomes were excellent in 17 cases, good in 11, fair in 4 and poor in 3 according to the Hohl＇s criterion. The rate of excellent and good of knee function were 80. 0%. Conclusions The clinical outcomes of the treatment of the tibial plateau fractures with double plate internal fixation are satisfactory.