临时跨关节外固定联合延期接骨板内固定治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折效果分析

Effect of temporary inter-articular external fixation and posterior plate fixation on Schatzker Ⅴ-Ⅵ tibial plateau fractures

背景:SchatzkerⅤ~Ⅵ型胫骨平台骨折的骨折类型复杂且关节面受损严重,目前治疗方法对创伤部位周围软组织保护不足,患者预后多较差。目的:研究临时跨关节外固定联合延期接骨板内固定治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折的效果。方法:收集2014年6月至2016年6月我院骨科收治的67例SchatzkerⅤ~Ⅵ型胫骨平台骨折患者临床资料。根据患者治疗方式不同分外固定组(n=34)和跟骨牵引组(n=33)。比较两组手术及预后相关指标差异。结果:外固定组入院到内固定时间、手术时间、术中出血量、住院时间方面显著优于跟骨牵引组(P<0.05)。结论:临时跨关节外固定联合延期接骨板内固定治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折是一种可选择的治疗方式。

Background： Schatzker Ⅴ-Ⅵ tibial plateau fractures are complex with severely destroyed articular surface, and current treatment cannot protect the soft tissue around wound part well, therefore the prognosis is mostly unsatisfactory. Ob Objective： To study the effect of temporary inter articular external fixation and posterior interlocking plate fixation on Schatzker type Ⅴ-Ⅵ tibial plateau fractures. Methods： The clinical data of 67 patients with Schatzker type Ⅴ-Ⅵ tibial plateau fractures were collected from June 2014 to June 2016 in our hospital. All patients were divided into two groups as external fixation group（n=34） and calcaneus traction group（n=33） according to the different treatment. Differences in surgical and prognostic indicators were compared between the two groups. Results： The time from hospitalization to internal fixation, operation duration, intraoperative blood loss and hospitalization time were significantly better in the external fixation group than in the calcaneal traction group（P〈0.05）. Conclusions： Temporary inter articular external fixation in combination with posterior interlocking plate fixation is a better way for the treatment of patients with Schatzker type Ⅴ-Ⅵ tibial plateau fractures.