外固定架结合有限固定分期治疗SchatzkerⅥ型胫骨平台骨折的临床分析

Clinical analysis of external fixator combined with limited internal fixation in phased treatment of Schatzker Ⅵ type tibial plateau fracture

目的 探讨应用组合式外固定架结合有限切开内固定分期治疗SchatzkerⅥ型胫骨平台骨折的临床效果。方法 选择2010年1月～2013年6月解放军第三○六医院收治的SchatzkerⅥ型胫骨平台骨折患者13例，采用Ⅰ期跨关节组合式外固定架撑开，3～4周后Ⅱ期改用组合式外固定架结合有限切开螺丝钉内固定治疗。对患者治疗效果进行分析。结果 随访6～18个月，平均12个月，所有患者骨折全部愈合，平均愈合时间5．1个月，平均拆除外固定架时间7．8个月。其中1例出现针道感染。膝关节功能按照Rasmussen评分标准：优6例、良5例、可2例，优良率84．6％。结论 组合式外固定架结合有限切开内固定分期治疗胫骨平台骨折，软组织并发症少，手术操作简单，膝关节功能恢复满意，是治疗复杂胫骨平台骨折的一种有效方法 。

Objective To explore the clinical effect of external fixator combined with limited internal fixation in phased treatment of Schatzker Ⅵ type tibial plateau fracture. Methods From January 2010 to June 2013, a total of 13 patients of Schatzker Ⅵ type tibial plateau fracture in the 306th Hospital of PLA were enrolled in this study, all patients were treated by combined type external fixator in phase Ⅰ and by combined type external fixator combined with limited internal fixation in phase Ⅰ after 3-4 weeks. The therapeutic effect was analyzed. Results Patients were followed up for 6-18 months, with an average of 12 months. All the patients＇ fracture were healed, the average healing time were 5.1 months. The average time of dismantling external fixator were 7.8 months. 1 case with pin-track infections was found. According to Rasmussen grading standard for knee joint function, 6 patients were excellent, 5 patients were good, 2 patients were passable, the rate of excellent and good was 84.6%. Conclusion Using combined type external fixator combined with limited internal fixation to treat tibial plateau fracture has little soft tissue complications, the operation is simple, the price is economic and the function of knee joint recover satisfactorily, it is an effective treatment for complex tibia plateau fractures.