锁定钢板内固定治疗复杂胫骨平台骨折60例临床分析

Clinical analysis on locking plate internal fixation in the treatment of 60 cases with complicated fracture of tibia plateau

目的探讨锁定钢板内固定技术治疗复杂胫骨平台骨折的临床效果。方法回顾性分析2011年1月～2012年12月，我科采取锁定钢板内固定治疗的复杂胫骨平台骨折60例（SchazkerIV24例，SchazkerV型20例，SchazkerVI6例），外侧联合内侧做双切口，辅以克氏针固定，观察术后的临床疗效。结果60例患者均获得随访，平均随访时间为18个月，平均手术时间为（52．3±3．5）rain，患者最早的负重平均时间为（6．1±2．1）周，骨折愈合时间为12—25周，1个月膝关节屈曲85～135，平均100．3；术后3个月膝关节屈曲90。～135。，平均118．0。，术后6个月膝关节屈曲95。～135。，平均125．0，术后1年膝关节屈曲120。～135。，平均124．0。，术后即刻、3个月及术后1年TPA及PA度数比较，无显著差异，伤口一期愈合率是95．0％，术后Rasmussen关节的功能评分优良率是83．75％。结论锁定钢板内固定治疗复杂胫骨平台骨折效果满意，可以有效恢复膝关节功能。

Objective To discuss the clinical effect of locking plate internal fixation in the treatment of complicated fracture of tibia plateau. Methods Sixty cases with complicated fracture of tibia plateau（24 cases in Schazker IV, 20 cases in Schazker V, 6 cases in Schazker VI） who took locking plate internal fixation with interior and lateral incision combined with Kirschner wire fixation treatment from January 2011 to December 2012 in our department were retrospectively analyzed, and postoperative clinical effects were observed. Results Sixty patients had been followed up, the average follow-up time was 18 months, the average operation time was （52.3 _＋ 3.5）min, the average＇ time of earliest weight was （6.1 ＋ 2.1）weeks, the fracture healing time was 12-25 weeks; The flexion degree of knee joint was 85~ - 135~ at 1 month after the operation, the average flexion degree was 100.3~ ; The flexion degree of knee joint was 90~ - 135~ at 3 months after the operation, the average flexion degree was 118.0~ ;The flexion degree of knee joint was 95~ -135~ at 6 months after the operation, the average flexion degree was 125.0~ ; The flexion degree of knee joint was 120~ ~ 135~ at 1 year after the operation, the average flexion degree was 124.0~ . There were not significant differences in TPA and PA degrees among immediately, 3 months and 1 year after the surgery, the primary wound healing rate was 95.0%, the excellent rate of postoperative Rasmussen knee joint function scoring was 83.75%. Conclusion Locking plate internal fixation in the treatment of complicated fracture of tibia plateau has satisfactory result, and can effectively restore knee joint function.