胫骨平台后侧骨折手术治疗进展

Progress of operative treatment of posterior tibial plateau fractures

胫骨平台后侧骨折易漏诊,主要累及胫骨平台内、外侧髁的后1/3。大部分需手术治疗,手术入路依骨折类型可选用外侧切口,后外侧切口,后侧"S"形或"L"切口及前后联合入路等。骨折复位多采用从后向前、从内向外的复位顺序,后内髁的解剖复位及有效固定至关重要,合并交叉韧带损伤的胫骨平台后侧骨折可同期或二期处理。

Posterior tihial plateau fractures are often missed, mainly involving the posterior 1/3 of lateral or medial condyle of the tibia plateau. Most need operative treatmenl, and according to the types of fracture, the operative route ean be lateral incision, dorsalateral incision, posterior ＂S＂ or ＂L＂ incision or combined anterior-posterior approach. The reduction of fractures is done from back to front, from inside to outside. Anatomical rednetion and effective fixation of posteromedial condyle are crucial. The combined cruciate ligament injury need treatment in the same operation or at the second period.