前外侧联合后内侧手术入路双钢板并植骨治疗复杂胫骨平台骨折

Double-plate fixationin and bone graft for treatment of complex tibial plateau fractures through anterolateral combined posteromedial operation approach

目的探讨经膝前外侧联合后内侧手术入路并植骨治疗复杂胫骨平台骨折的临床疗效。方法 2010年1月～2013年1月,应用前外侧联合后内侧手术入路双钢板内固定并植骨治疗复杂胫骨平台骨折患者65例,骨折按照Schatzker分型：Ⅴ型43例、Ⅵ型22例。术后早期功能锻炼,随访时采用Rasmussen膝关节功能评分和影像学评分标准评价临床治疗效果。结果 51例获得随访,随访时间12～18月,平均14.5月,切口均获一期愈合,骨折愈合时间为4～6月,平均5.5月。伤口无感染,钢板无松动、折断,术后1年膝关节功能评分：优25例,良18例,可6例,差2例,优良率为84.3%。结论经膝前外侧联合后内侧手术入路双钢板内固定并植骨治疗复杂胫骨平台骨折,术后早期功能锻炼,膝关节功能恢复良好,临床疗效满意。

Objective To explore the clinical effects of double-plate fixationinandbone graft for the treatment of complex tibial plateau fractures through anterolateral combined posteromedial operation approach. Methods A total of 65 patients with complex tibial plateau fractures were treated by anterolateral combined posteromedial operation approach, doubleplate fixation andbone graftduring January 2010 to January 2013. According to Schatzker classification, 43 cases were type Ⅴand 22 were type Ⅵ. The Rasmussen score and imaging score were used to evaluate the clinical therapeuticeffects.Results Of the 65 patients, 51 completed a followed-up visitthrough 12 to 18 months（averagely 14.5 months）. The fracture healing time ranged 4 to 6months（averagely 5.5 months）. The steel plate showed no loose, break or exposed.The score of knee function 1 year after the surgery showed excellent in 25 cases, good in 18, fair in 6 and poor in 2, with an excellent and good rate was 84.3%. Conclusion The curative effect of that double-plate fixation andbone graft to treat complex tibial plateau fracture patients through anterolateral combined posteromedial operation approach was good and with less complications and more quick recovery of knee function after operation.