健侧高尔夫钢板内侧固定治疗累及中上段胫骨平台内侧髁骨折的疗效分析

The effects of medial fixation by the contralateral golf plate in treating the medial condyle fracture of the tibial plateau involving the middle and upper segments

目的探讨健侧高尔夫钢板内侧固定治疗累及中上段胫骨平台内侧髁骨折的临床疗效分析。方法回顾性分析2007年2月—2011年3月罗田县人民医院收治的18例累及中上段胫骨平台内侧髁骨折,其中男性12例,女性6例;年龄32~54岁,平均45.5岁。致伤原因:道路交通伤13例,高处坠落伤5例;左侧13例,右侧5例。合并腓总神经损伤1例,开放性骨折4例,其中Gustilo I型2例,II型2例,无腘窝部血管损伤。运用健侧高尔夫钢板内侧固定,手术距受伤时间8~14d,平均10d。结果 18例患者术后随访时间14~30个月(平均20个月),骨折均获骨性愈合,愈合时间为12~24周,平均18周。术后早期1例出现伤口浅表感染,经换药处理后治愈;1例出现切口表皮坏死,经清创换药后愈合。末次随访时依据Hohl膝关节功能评分标准评定,优10例,良5例,可3例,优良率为83.3%。结论健侧高尔夫钢板内侧固定治疗累及中上段胫骨平台内侧髁骨折的临床疗效良好,是一种可供选择的固定方法。

Objective To explore the clinical effects of medial fixation by the contralateral golf plate in treating the medial condyle fracture of the tibial plateau involving the middle and upper segments. Methods Between Feb. 2007 and Mar. 2011,18 cases of the medial condyle fracture of the tibial plateau involving the middle and upper segments in Luotian People＇s Hospital were retrospectively analyzed. There were 12 males and 6 females,with an average age of 45. 5 years（ from 32 to 54 years）. Thirteen cases were injured from road traffic accidents,5 were from high falling. There were 13 cases on the left and 5 cases on the right. One case was complicated with total peroneal nerve injury,4 cases with open fracture,including 2 cases of Gustilo I,2 cases of type II,and no popliteal fossa vessel injury occured. Patients were operated 8-14 d after injury. The fixation of the contralateral golf plate was used and the clinical effects were observed during follow-up. Results Eighteen cases were followed up for 14-30 months（ mean,20 months）. All fractures healed after 12-24 weeks（ mean,18 weeks）. Early postoperative superficial wound infection occurred in 1 case,and was cured by dressing. One case showed epidermal necrosis. At the end of the follow-up period,the function of Hohl knee joint functional score was evaluated,10 cases were excellent,good in 5 cases,fair in 3 cases,and the excellent and good rate was 83. 3%. Conclusion The clinical curative effect of medial fixation by the contralateral golf plate in treating the medial condyle fracture of the tibial plateau involving the middle and upper segments is good,which is an alternative fixation method.