漂浮体位下三柱内固定治疗复杂胫骨平台骨折的临床疗效

The clinical efficacy of floating position fixation of complex tibial plateau fractures in three columns

目的分析漂浮体位下三柱内固定治疗复杂胫骨平台骨折的临床效果。方法用回顾性研究方法,选取2012年1月至2014年12月收治的复杂胫骨平台骨折12例患者,采用漂浮体位下三柱内固定治疗。其中Schatzker方法分型Ⅴ型3例,Ⅵ型9例,均为三柱骨折。在漂浮体位下联合后内侧倒L形与前外侧入路方法手术治疗,观察患者术后的各项相关指标。结果在患者术后的5~36个月进行随访,检查了解患者骨折愈合情况及膝关节功能恢复情况。12例患者术后一年,膝关节HSS评分74~97分,平均88.7±0.7分。无一例出现不愈合、内固定松动、感染等不良临床表现。结论复杂胫骨平台骨折在漂浮体位下联合后内侧倒L形与前外侧入路,对骨折处的愈合、固定、复位有显著的疗效,并可以预防出现并发症如术后骨折再移位、关节面塌陷等,膝关节功能的恢复在手术后一年内可以达到患者满意的效果。

ObjectiveTo evaluate the clinical efficacy of floating position fixation of complex tibial plateau fractures in three columns.MethodsFrom May2012to April201412cases of patients with complex tibial plateau fractures in three columns with floating position fixation were selected.According to Schatzker method for fracture,patients were classified,includingⅤtype3cases,Ⅵtype9cases,all were three-column fracture.ResultsAfter5to36months of postoperative follow-up,the fracture healing and functional recovery of the knee were checked.One year after surgery,knee HSS score of12patients were74to97points,an average of88.7points.No nonunion,infection,loosening and other clinical manifestations appeared.ConclusionComplex tibial plateau fractures in the joint floating position combined with inverted L-shaped medial and anterolateral approach is effect for the fracture reduction and fixation,and can prevent further displacement after the fracture such as articular surface collapse and other complications and knee function can restore to satisfactory results after a year.