SchatzkerⅣ~Ⅵ型胫骨平台骨折的手术疗效

Surgical effect for Schatzker type Ⅳ～Ⅵ tibial plateau fractures

目的探讨SchatzkerⅣ-Ⅵ型胫骨平台骨折的手术疗效。方法对29例SchatzkerⅣ-Ⅵ型胫骨平台骨折患者采用L-Tcp加压钢板及拉力螺钉内固定术治疗。结果患者均获得随访,时间14-27个月。骨折均临床愈合,时间18-29周。并发症：1例术后并发腘静脉血栓,予以抗血栓治疗后治愈;1例未达到解剖复位;2例出现切口感染,经伤口换药二期修复后治愈。末次随访膝关节活动度：伸-5°-5°,屈90°-125°,活动范围85°-130°。按照Rasmussen膝关节功能评分标准评定：优13例,良11例,可3例,差2例。结论手术治疗SchatzkerⅣ-Ⅵ型胫骨平台骨折应处理好膝关节周围合并伤,注重关节面复位质量、坚强内固定及术后功能锻炼。

Objetive To investigate the surgical curative effect for Schatzker type Ⅳ-Ⅵ tibial plateau fractures.Methods Twenty-nine cases of Schatzker type Ⅳ-Ⅵ tibial plateau fractures were treated with L-Tcp compression plate and lag screw internal fixation. Results The patients were followed up for 14-27 months,fractures were healed in 18-29 weeks. Complications： 1 case of popliteal vein thrombosis was cured after anti thrombotic treatment; 1 case didn＇t achieve anatomical reduction; infection occurred in 2 patients,with wound dress changing and antibiotic treatment,both were discharged. At the end of follow-up,range of the knee joints was- 5°-5°,range of the knee flexion was 90°-125°,knee range of motion was 85°-130°. Rasmussen grading method was applied to evaluate their knee joint functions; 13 cases were excellent,11 were good,3 fair and 2 poor. Conclusions Operative treatment for Schatzker type Ⅳ-Ⅵ complex fractures of tibial plateau should deal with knee injury,pay attention to joint reduction quality,rigid internal fixation and postoperative function exercise.