钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折的疗效

The efficacy of plate internal fixation combined with calcium phosphate cement for treatment of tibial plateau fractures

目的探讨钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折的临床疗效。方法采用钢板内固定联合磷酸钙骨水泥填充关节面塌陷治疗38例胫骨平台骨折患者。结果患者均获得随访,时间15～24个月。术后6个月患者均可完全负重行走。骨折骨性愈合时间为6～8个月。末次随访时,膝关节活动度为115°～145°,无屈曲挛缩畸形;膝关节功能采用Rasmussen胫骨平台骨折评分评定疗效:优21例,良12例,可5例,优良率为86.8%。1例患者在术后3个月时发现关节面塌陷(下沉深度为1.5 mm),其余患者至末次随访时未发现关节面塌陷。结论采用钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折,能够有效阻止关节面复位再丢失,临床疗效和影像学结果满意,术后并发症发生率较低。

Objective To investigate the clinical efficacy of plate internal fixation combined with calcium phosphate cement for treatment of tibial plateau fracture. Methods The 38 patients with tibial plateau fractures were treated by plate internal fixation combined with calcium phosphate cement for filling collapse of joint surface. Results All patients were followed up for 15 ～ 24 months. All patients could reach full weight bearing at 6 months after surgery; the time of fracture healing was 6 ～ 8 months. At the final follow-up,the range of motion was 115° ～ 145°,without flexion contracture deformity; there were 21 patients with excellent results,12 good,5 fair,the excellent-good rate was 86. 8%,according to Rasmussen scores for knee function. One patient with articular surface subsidence（ subsidence depth of 1. 5 mm） was observed at 3 months after surgery,the other patients were without articular surface subsidence. Conclusions The plate internal fixation combined with calcium phosphate cement for treatment of tibial plateau fractures,can provide adequate mechanical support to prevent articular fragment subsidence,which can achieve satisfactory clinical and radiographic results with a low rate of complication.