双反牵引、微创复位及raft技术治疗后内及后外侧胫骨平台骨折

Posteromedial and posterolateral tibial plateau fractures after homeopathic double reverse traction,minimally invasive reduction and raft technique

目的分析双反牵引闭合复位,内外侧经皮置入双钢板治疗后内及后外侧胫骨平台骨折的效果,评估复位质量及功能恢复情况。方法回顾性收集2015年9月至2017年12月,山东大学齐鲁医院(青岛)创伤骨科收治的后内及后外侧胫骨平台骨折19例,其中男性11例,女性8例,年龄37～73岁,平均56.71岁。均采取双反牵引闭合复位,内外侧经皮置入双钢板治疗术后给予X线及三维CT再次评估复位情况。同时随访评估功能恢复情况。结果 17例患者获得随访,随访时间6～14个月(平均10.1个月),骨折均获得愈合,无畸形愈合及骨不连。1例切口愈合不良,经换药后切口愈合。采用美国特种外科医院(HSS)膝关节评分,优14例,良3例。结论应用双反牵引、微创技术植入钢板及双钢板raft技术固定治疗后内及后外侧胫骨平台骨折具有术中快速复位,软组织并发症少,可避免骨折塌陷,畸形愈合优点。这种方法是治疗后内侧及后外侧胫骨平台骨折的有效手段,值得临床推荐。

Objective To analyse the effects of homeopathic double-reverse traction with medi- al and lateral percutaneous double plate in the treatment for posteromedial and posterolateral tibial pla- teau fractures, and further analysis the quality of restoration and functional recovery. Methods A retro- spective collection of 19 cases of posteromedial and posterolateral tibial plateau fractures in the depart- ment of Trauma and Orthopaedics of Qilu Hospital from September 2015 to December 2017, including 11 males and 8 females, aged 37-73 years old, with an average of 56.71 years old. All patients under- went homeopathic double-reverse traction closed reduction and medial and lateral percutaneous double plate were used, reduction were using X-ray and three-dimensional CT scan. Meanwhile functional re- covel7 were followed-up. Results Seventeen patients were followed up for 6 to 14 months （mean 10.1 months）. All fi＇actures were healed without malunion and nonunion. One case had poor healing of the IN- cision, and the incision healed after dressing change. Patients were evaluated with the US Special Sur- gery Hospital （HSS） knee score, excellent in 14 cases, and good in 3 cases. Conclusions The postero- medial and posterolateral tibial plateau fractures with homeopathic double-reverse traction, minimally in- vasive technique and double-plate raft technique have rapid intraoperative reduction and less soft tissue complications, which can avoid fracture collapse and malFOrmation. This method is an effective method for the treatment of posteremedial and posterolateral tibial plateau fractures and worthy clinical recom- mendation.