骨间入路治疗胫骨平台骨折的疗效观察

Observation on curative effect of interosseous approach for treating tibial plateau fracture

目的探讨骨间入路复位法植骨治疗胫骨平台骨折的临床疗效。方法选择胫骨平台骨折23例患者,Schatzker分型Ⅱ型9例,Ⅲ型6例,Ⅴ型8例。术中采用外侧切口保护关节囊的骨间入路治疗Schatzker分型Ⅱ、Ⅲ型骨折,同时联合后外侧入路治疗Ⅴ型骨折。结果患者术后伤口均一期愈合,未见感染、坏死等表现。随访1~2年,术后X线片,未出现复位后骨折的后期塌陷,全部骨性愈合,未见内固定失效表现。术后Rasmussen评分,优16例,良5例,可2例,差0例,优良率91.1%。结论骨间入路可以减少对膝关节软组织的剥离,有利于早期康复活动,促进术后膝关节功能的恢复,临床效果满意。

Objective To investigate the clinical effect of interosseous approach reduction bone grafting for treating tibial plateau fracture.Methods Twenty-three patients with tibial plateau fracture were selected,including 3 cases of typeⅡ,6 cases of typeⅢand 8 cases of typeⅤby using the Schatzker classification type.Meanwhile the typeⅤfracture was treated by combined lateral approach.Results The postoperative wounds in the patients obtained the primary healing without the phenomena of infection and necrosis.After 1-2 years follow up,no late collapse after fracture reduction occurred,all were bony healing,no manifestation of internal fixation invalidation was found.According to the postoperative Rasmussen scoring standard,16 cases were excellent,5 cases were good,2 cases were fair and 0 case was poor,the excellent and good rate was 91.1%.Conclusion The interosseous approach can reduce the soft tissue stripping of knee joint,is benificial to the early rehabilitation activities,promotes the recovery of knee joint function,and clinical effect is satisfactory.