复杂胫骨平台骨折的手术疗效分析

Analysis of surgical treatment and effect of complex tibial plateu fracture

目的：探讨复杂胫骨平台骨折手术治疗与疗效。方法：回顾性分析我院2007年1月∽2012年1月32例Schatzker V、Ⅵ型胫骨平台骨折患者。32例均接受切开复位钢板螺钉内固定治疗，骨缺损处取自体髂骨或同种异体骨植骨。对患者进行术后至少12个月随访，并评估术后临床及影像学效果。结果：32例均获得随访，时间12∽60个月，平均19个月，所有骨折均获得愈合，其中2例术后伤口出现脂肪液化，1例复位丢失。术后12个月膝关节屈曲度80°∽135°。膝关节功能HSS评分：优23例，良6例，可3例，优良率达到90．6％。结论：外科手术是治疗复杂胫骨平台骨折十分有效的方法，正确选择手术入路、骨折复位固定、早期康复锻炼是影响复杂胫骨平台骨折患者术后疗效的主要因素。

Objective：To investigate the clinical outcome of surgical treatment of the complex tibial plateu fracture （ TPF） .Methods：A retrospective review was performed for surgical treatment for the complex tibial plateu fracture of Schatzker V and Ⅵin 32 patients from January 2008 to January 2012.32 cases were accepted steel screw internal fixation ,and bone defect filling with the ilium or allogeneic bone graft.Assessment of postoperative clinical and radiographic results was done after 12 months.Results：The patients were followed up for 12∽60 （ mean 10） moths.The fractures were healed in all the cases .Postoperation the wound fat liquefaction in 2 and Reset lost in 1.The flexion of knee was 80 °∽135 °after 12 months.According to HSS knee function score system , there were 23 excellent cases , 6 good , 3 cases, fine rate reached 90.6%.We treated 32 cases of TPF using the external fixator Lateral locking plate and double plates were used in 22 aged patients with tibial plateau fracture of Schatzker V and Ⅵ.Assessment operation effect was done by evaluation of postoperative complications and flexion , function, and stability of knee.Results：All patients were followed up for 7∽32 months.The flex-ion of the knee was 80°∽135°.According to HSS knee function score system , there were 14 excellent cases,6 good and 3 fair（fine rate reached 12%） .Conclusion：Surgical treatment of complex tibial plateau fractures was a very effective method .The correct selection of surgical approach , fracture reduction and fixation , early rehabilitation exercise could affect the postoperative curative effect of patients with complex tibial plateau fractures .