双反牵引微创治疗后外侧胫骨平台骨折的疗效分析

Bidirectional minimally invasive treatment of posterolateral tibial plateau fractures

目的评价双反牵引微创方法治疗后外侧胫骨平台骨折的疗效。方法回顾性分析2016年3月至2016年12月河北医科大学第三医院创伤急救中心收治的14例后外侧胫骨平台骨折患者(均符合纳入排除标准),男性9例,女性5例,年龄(48±11)岁。所有患者均采用张氏牵引复位器闭合复位治疗骨折,骨折复位后采用经皮微创置入接骨板固定。采集手术时间、术中失血量等数据。术后随访行影像学检查,末次随访根据美国纽约特种外科医院(HSS)评分及国际膝关节文献委员会(IKDC)功能评分评估患侧膝关节功能恢复情况。结果所有患者均获得平均(6.8±1.3)个月的随访。手术平均时间为(63±21)min;术中出血量平均(105±21)ml。Rasmussen影像学评分优良率达100%。膝关节HSS评分为(86±6)分;IKDC评分为(80±11)分。术后未出现切口感染、切口不愈合、内固定物松动及断裂、复位丢失等并发症。结论在治疗后外侧胫骨平台骨折时,双反牵引微创技术是一种创伤小、恢复快、简单快捷的治疗方式。

Objective To evaluate the effectiveness of Zhang's bidirectional device minimally invasive treatment of lateral tibial plateau fractures.Methods From March2016to December2016,14patients admitted to the trauma center of the hospital of hebei medical university who suffered posterolateral tibial plateau fractures were included into our study.All the patients met the inclusion and exclusion criteria.There were nine males and five females with average age of(48±11)years.All the patients were treated using Zhang's bidirectional device minimally invasive treatment and followed up regularly.The treatment was evaluated according to the surgical time,blood loss and functional outcomes by hospital of special surgery(HSS)scores and the international knee documentation committees(IKDC)scores.Results All patients were followed up for an average of(6.8±1.3)months(range6~8months).The satisfactory rate was100%according to Rasmussen radiological system,and the mean HSS score was(86±6),the mean IKDC score was(80±11).There were no surgical site infection,delayed union and other complications in our patients.Conclusions Zhang's bidirectional minimally invasive method is a convenient and effective treatment for posterolateral tibial plateau fractures.