摘要
目的探讨空心钉结合髓内钉固定治疗同侧胫骨平台伴胫骨干骨折的方法和疗效。方法采用空心钉结合髓内钉固定治疗同侧胫骨平台伴胫骨干骨折12例,先以空心钉固定胫骨平台骨折,部分关节面粉碎塌陷较严重、怀疑合并半月板及韧带损伤者使用关节镜辅助探查及复位胫骨平台关节面,再以髓内钉固定胫骨干骨折。结果本组获平均17(8~33)个月随访,均获得骨性愈合,胫骨平台骨折平均愈合时间为12周,胫骨干骨折平均愈合时间为23周。疗效根据Lowa膝关节功能评价标准评定:优8例,良3例,可l例。结论空心钉结合髓内钉既有效固定了两处骨折。又充分保护了软组织,是治疗同侧胫骨平台伴胫骨干骨折的有效方法。
Objective To evaluate the treatment methods and clinical results of cannulated screws combined with intramedullary naris in the treatment of ipsilateral tibial plateau and shaft fractures. Methods Twelve patients with ipsilateral tibial plateau and shaft fracture were treated with cannulated screws and intramedullary nails. All cases were firstly operated with cannulated screw to fix tibial plateau fractures. If there were severe erushing edlapse of part of the articular surface_k- tibial plateau and suspected meniscus and ligament damage, arthroscopy assisted detection was perfomed and articular surface of tibial plateau was restored, and then the intramedullary nail was used to fix tibial shaft fractures. Results All of 12 patients were followed up with a mean of 24 months (14 to 36 months). All patients obtained bone union. The tibial-plateau fractures united after an average of 12 weeks, and the tibial fractures united after an average of 23 weeks. According to Lowa knee scores, excellent result was obtained in 8 cases, good in 3 cases, fair in 1 case. Conclusion The carmutated screws combined with intramedullary nails not only fixes two fractures effectively, but also fully protectsthe soft tissue, and it is the effective method of treatment of ipsilateral tibial plateau and shaft fractures.
出处
《中国骨与关节损伤杂志》
2013年第12期1149-1151,共3页
Chinese Journal of Bone and Joint Injury
基金
上海市医学重点专科建设计划基金资助(ZK2012B03)
关键词
胫骨平台骨折
胫骨干骨折
空心钉
髓内钉
内固定
关节镜
Tibial plateau fracture
Tibial shaft fracture
Cannulated screws
Intramedullary nail
Internal fixation
Arthroscopy