胫骨内侧平台骨折合并外侧副韧带损伤的修复方案及其疗效相关研究

The repair scheme and its curative effect of the fracture of the tibial medial platform fracture combined with lateral collateral ligament injury

目的探讨胫骨内侧平台骨折合并外侧副韧带损伤的修复方案及其疗效。方法回顾性分析2015年5月~2017年2月共收治78例胫骨内侧平台骨折合并外侧副韧带损伤患者,其中保守治疗32例,手术治疗46例,其中Ⅰ期修复28例,Ⅱ期修复18例。Ⅰ期修复组采用骨折均切开复位内固定和韧带修复术治疗,Ⅱ期修复组采用缝合匠肌动力修复、髂胫束静力修复、髂胫束加1/2半腱肌静力修复治疗。对患者进行随访,观察术后修复情况。结果经过随访统计,保守治疗组膝关节功能评定结果为81.25%,Ⅰ期修复组为100.00%,Ⅱ期修复组为94.44%,提示Ⅰ期修复组优良率最高。修复的膝外侧副韧带损伤部位以中间断裂为主。结论对于胫骨平台骨折合并外侧副韧带损伤的患者,Ⅰ期修复效果理想,应着重注意修复术后中间断裂情况,值得进一步研究。

Objective To explore the repair scheme and its curative effect of the fracture of the tibia medial platform fracture combined with the lateral collateral ligament injury.Methods Retrospectively analyzed in May 2017 to February 2015 were treated 78 cases of medial tibia platform fracture merge the lateral collateral ligament injury patients,32 cases of conservative treatment,surgical treatment,46 cases ofⅠrepair 28 cases,18 casesⅡphase.Ⅰusing fracture repair group were for the treatment of open reduction and internal fixation and ligament repair,Ⅱrepair suture the artisan muscle power,the iliotibial band static repair,the iliotibial band plus 1/2 half tendons static repair treatment.The patient was followed up and the repair was observed.Results After a follow-up statistics,knee joint function assessment results conservative treatment group is 81.25%,Ⅰrepair group was 100.00%,Ⅱrepair group was 94.44%,promptⅠrepair group was the highest.The injured part of the lateral collateral ligament of the repaired knee is mainly in the middle.Conclusion For tibial plateau fractures of the lateral collateral ligament injury combined,Ⅰrepair effect is ideal,should focus on repairing postoperative middle fracture,deserves further research.