关节镜技术和三柱锁定钢板固定治疗胫骨平台骨折

Arthroscopic technique and three column locking plate fixation in the treatment of tibial plateau fractures

目的探讨关节镜技术和三柱锁定钢板治疗胫骨平台骨折的临床效果。方法采用关节镜技术和三柱锁定钢板固定治疗51例胫骨平台骨折,SchatzkerⅠ～Ⅲ型35例,Ⅳ-Ⅵ型16例;其中,胫骨髁间嵴骨折并前交叉韧带损伤8例,后交叉韧带止点撕脱骨折8例,半月板损伤5例。结果本组随访12～24个月,平均13.6个月。膝关节功能参照Rasmussen评分:优24例,良20例,可6例,差1例,优良率达86.3%。无切口坏死,无固定失败及骨外露发生。有1例伤口感染。结论采用关节镜技术和三柱锁定钢板固定各种胫骨平台骨折是一种可靠方法。

Objective To investigate the efficacy of three columns of locking plate under arthroscopic technique in the treatment of tibial plateau fracture. Methods Using arthroscopic techniques and three column locking plate fixation, 51 patients with tibial plateau fracture underwent surgical procedure from Jan 2007 to Feb 2012 including 35 cases of SchatzkerⅠ -Ⅲ and 16 cases of Ⅳ-Ⅵ. Among them, tibial intercondylar crest fracture with anterior cruciate ligament injury and posterior cruciate ligament insertion avulsion fracture were in 8 cases respectively and meniscus injury in 5 case. Results All patients were followed up for 12-24 months,an average of 13.6 months. Knee function was evaluated by Rasmussen score, excellent in 24 cases, good in 20 cases, moderate in 6 cases, and poor 1 case, excellent and good rates were in 86.3%. No necrosis was found on the skin of incision, one case occurred wound infection No failure of plate fixation and bone exposure occurred in all patients. Conclusion The locking plate and three column fixation under arthroscopy technique is a reliable method in treatment of tibial plateau fracture.