胫骨平台骨折的手术治疗分析

The Key to Surgical Treatment of Tibial Plateau with Internal Fixation

目的:探讨胫骨平台骨折内固定治疗思路和方法的选择。方法:自2008年1月至2012年8月共收治胫骨平台骨折87例,其中男68例,女19例,年龄20-74岁,平均43.9±0.6岁,开放性损伤2例,闭合型损伤85例,按照schatzker分型标准Ⅰ型5例,Ⅱ型34例,Ⅲ型4例,Ⅳ型6例,Ⅴ型18例,Ⅵ型20例。根据分型,分别给于单侧解剖钢板60例,双钢板内固定25例,单纯螺钉固定2例。结果:全部病例获得随访。随访时间8-24个月,平均14.3个月,采用Rasmussen评分标准评定:优55例,良22例,可9例,差1例,优良率88.5%。结论:根据胫骨平台骨折的特点而选择不同的手术入路及内固定方法,术中植骨将减少术后胫骨平台的下沉,术后功能锻炼,可以明显的改善胫骨平台的治疗效果。

Objective：To explor the option of the surgical treatment of tibial plateau with internal fixa-tion.Method：From June 2008 to August 2012,87 patients with tibial plateau fractures were treated in our hospital,which were 68 males and 19 females with the average age of 43.9 years ranging from 20 to 74 years. The closed fracture were 85, and the open were 2.According to schatzkers classification , the fractures were diagnosed as typeⅠin 5, typeⅡin 34, type Ⅲin 4, typeⅣin 6, typeⅤin 18, typeⅥin 20.unilateral In-ternal Fixation with plate and hone implate were 60 cases, Internal Fixation with double plate and hone im-plate were 25 cases, unilateral condylar cannulaed nail fixation were 2 cases.Result：87 patients were fol-lowed up from 8 to 24 months（average 14 .3months） .According to Rasmussen point knee rating system , 55 patients were excellent , 22 good, 9 fair and 1 poor.The excellent and good rate was 88.5%.Conclusion：The key to the satisfited results of the surgical treatment of tibial plateau with internal fixation are as follow as, to maker individual operation according to the tibial plateau fracture , The bone graft during the operation will decrease tibial plateau fracture sinking after operation .And the proper physical exercises without weight bearing promoting the clinical effect .