用经后外侧入路支撑钢板内固定术治疗涉及后柱的外侧胫骨平台骨折的效果

Analysis of the effect of internal fixation of the lateral tibial plateau fracture involving the posterior column

目的 :探讨用经后外侧入路支撑钢板内固定术治疗涉及后柱的外侧胫骨平台骨折的临床效果。方法 :将2010年10月至2011年12月期间广东省阳春市中医院收治的16例涉及后柱的外侧胫骨平台骨折患者作为研究对象。对这16例患者均进行经后外侧入路支撑钢板内固定术。然后,观察这些患者的治疗效果。结果 :经过治疗,这16例患者的骨折均愈合,其骨折愈合的平均时间为16周。在这16例患者中,有2例患者患处的表皮出现部分坏死及渗出的症状,经换药处理后其坏死处的表皮愈合;其均未发生手术切口感染、钢板外露等并发症。术后1年,这16例患者改良的膝关节HSS评分平均为87.5分。对这16例患者进行术后影像学评估的结果为,有14例患者的关节面塌陷<2mm,有2例患者的关节面塌陷约为4mm;术后即刻与术后1年这16例患者的胫骨平台内翻角和胫骨平台后倾角相比,差异无统计学意义(P>0.05)。结论 :用经后外侧入路支撑钢板内固定术治疗涉及后柱的外侧胫骨平台骨折的效果显著。

objective： to explore the clinical effect of the treatment of lateral tibial plateau fracture involving the posterior column by internal fixation with the posterior lateral approach. Methods： sixteen cases of lateral tibial plateau fractures involving the posterior column were treated in yangchun hospital of traditional Chinese medicine in guangdong province from October 2010 to December 2011. All 16 patients were treated with post lateral approach and internal fixation. Then, observe the treatment effect of these patients. Results： after treatment, the fractures of these 16 patients were all healed, and the average time of fracture healing was 16 weeks. In 2 of the 16 patients, partial necrosis and exudative symptoms occurred in the epidermis of the affected area. No surgical incision infection, plate exposure and other complications occurred. One year after surgery, the 16 patients had an average HSS score of 87.5. The postoperative imaging evaluation of these 16 patients was as follows： joint surface collapse of 14 patients was 2 mm, and joint surface collapse of 2 patients was about 4 mm. There was no statistically significant difference between the tibial plateau turn Angle and the tibial plateau tilt Angle immediately after surgery and 1 year after surgery（P 0.05）. Conclusion： the treatment of lateral tibial plateau fractures involving the posterior column by internal fixation with posterior lateral approach is effective.