双钢板固定结合植骨治疗V、VI型胫骨平台骨折21例

Double plate fixation combined with bone graft in the treatment of 21 cases of V, VI type of fracture of tibial plateau

目的：探讨双钢板固定结合植骨治疗V、VI型胫骨平台骨折的注意事项和提高疗效的方法。方法2009年1月~2012年9月对21例胫骨平台骨折进行治疗，患者按照 Schatzker 分类法进行骨折分型为V、VI型，均采用双钢板固定方式进行手术治疗并进行充分植骨，术后及时进行膝关节功能锻炼。结果本组21例患者的手术均顺利成功，术后经8~24个月随访，手术切口均1期愈合，骨折均临床愈合，植骨无坏死发生。经疗效评定，优12例，良6例，中2例，差1例。结论双钢板固定结合植骨治疗V、VI型胫骨平台骨折，骨折稳定效果好，关节面复位满意，骨折愈合率高，并发症少，膝关节功能恢复好等优点，是一种比较有效的方法。

Objective To discuss the considerations of double plate fixation combined with bone graft in the treatment of V, VI type of fracture of tibial plateau and the methods to improve the curative effect. Methods 21 cases of fracture of tibial plateau from January 2009 to September 2012 were V, VI type according to the Schatzker classification, and adopt double plate fixation method for the surgical treatment and bone graft fully, and postoperative timely functional exercise of knee joint. Results 21 patients had successful operation, and were followed up for 8-24 months after operation, all operation incisions healed at the first period, all fractures had clinical healing, no necrosis happened during the process of bone graft. The evaluation of curative effect showed that there were excellent in 12 cases, good in 6 cases, fair in 2 cases, poor in 1 case. Conclusion Double plate fixation combined with bone graft in the treatment of V, VI type of fracture of tibial plateau has good effect in fracture stability, satisfactory joint surface resetion, high fracture healing rate, fewer complications, and good knee functional recovery, and is an effective method.