水平带状钢板在胫骨平台骨折治疗中的应用进展

Application progress on horizontal belt plate in the treatment of tibial plateau fracture

治疗胫骨平台外侧髁的粉碎骨折(累及整个外侧、后外侧、前外侧),传统的解剖型钢板,仅能放在外侧髁的外侧面,其近端的横臂长度有限,至多能打入4枚水平方向螺钉,因包绕范围不足,部分骨折块难以得到有效固定。水平带状钢板(horizontal belt plate)的固定方式,是将较薄的直形钢板(如3.5 mm系列的1/3管型板、重建板、2.7 mm系列板等)经折弯后横向放置,或对较薄的T形钢板予以改造,剪去横臂的一边,再将其纵臂进行折弯后横向放置,如此则增加了水平方向的包绕范围,对破裂粉碎的关节面皮质边缘,以横向聚拢的方式对骨块进行支持固定,是近年来胫骨平台骨折治疗的重要进展。

In the treatment of comminuted fracture of lateral condyle of tibial plateau（ involving the entire lateral,posterolateral,and anterolateral）,traditional anatomical plate can only be placed on the lateral side of lateral condyle;the proximal arm length is limited for up to four horizontal screws; due to the lack of coverage,part of the fractures cannot be effectively fixed. The fixation with horizontal belt plates is bending straight thin plates and then placing horizontally（ such as 3. 5 mm 1/3 tube plate,reconstruction plate,and 2. 7 mm plate）,or modifying thin T-shaped plates by cutting off the side of transverse arm bending trailing arm,and placing horizontally. Such practice increases the coverage in horizontal direction of cracked articular surface. It is an important progress of lateral gather fixation in the treatment of tibial plateau fractures in recent years that it supports and fixes bone blocks in a horizontal manner. This article gave a summary on the topic.