复位内固定治疗胫骨平台骨折36例临床研究

Clinical research of internal fixation treatment for 36 cases of tibial plateau fracture

目的探讨开放复位内固定治疗胫骨平台骨折的临床疗效及围手术期注意事项,为临床治疗提供参考。方法回顾性分析2009年1月~2014年9月经复位、内固定治疗的36例胫骨平台骨折患者,骨折类型按Schatzker分型,其中I型2例,Ⅱ型15例,Ⅲ型4例,Ⅳ型3例,V型5例,Ⅵ型7例。术前根据不同的骨折类型和局部软组织条件确定手术的时机和方法,术后加强康复锻炼。全部进行随访6个月,依据Rasmussen膝关节功能分级评价治疗效果。结果本组36例随访患者,随访6~36个月,通过Rasmussen膝关节功能评定,其中优26例,良6例,可4例,优良率达88.89%。结论复位内固定是治疗胫骨平台骨折最好方法。术前对骨折情况及合并伤进行全面评估,选择合适的手术时间和固定方式,术后进行功能锻炼对关节功能恢复非常重要。

Objective： Objective： To through the analysis of the clinical efficacy of the internal fixation for tibial plateau fractures,provide reference for clinical doctors. Methods： The clinical data of 36 patients of tibial plateau fractures from January 2009 to September 2014 were retrospectively analyzed. The 36 cases were classified according to Schatzker classification. There were 2 cases in typeⅠ,15 in Ⅱ,4 in Ⅲ,3 in Ⅳ,5 in Ⅴ,7 in Ⅵ. Pre- operative positive control with underlying diseases,Full assessment of the fracture and soft tissue damage inpreoperative,to determine the timing of surgery,to give the appropriate surgical treatment. Guide patients to do postoperative rehabilitation training and functional exercise.All the patients were followed up for 6 months. Application Rasmussen knee score table sports injury score. Results： All the cases were followed- up in postoperative 6 ~ 36 months,Application Rasmussen knee table sports injury score. the function of the knees showed excellent in 26 cases,good in 6 cases,and fair in 4 case. The excellent and good rate was88. 89%. Conclusions： Internal fixation is the best treatment for tibial plateau fractures. In order to get the optimal therapeutic efficacy,To fully assess the pre- operative fracture and combined injuries,choose a right way of operation and fixed. Scientific postoperative functional exercise is particularly important on the restoration of joint function.