双钢板结合克氏针治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折

Double plates combined with Kirschner wire in treatment of Schatzker typeⅤ,Ⅵtibial plateau fractures

目的探讨双钢板结合克氏针治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的疗效。方法对30例SchatzkerⅤ、Ⅵ型胫骨平台骨折患者行双钢板结合克氏针内固定治疗,术后遵循“早活动晚负重、循序渐进”的原则行膝关节功能锻炼。记录切口愈合情况、骨折愈合情况、膝关节活动范围,采用Rasmussen评分标准评价疗效。结果28例切口愈合良好;2例外侧切口出现红肿、少量渗出,经伤口换药及对症处理后愈合。患者均获得随访,时间12~24个月。骨折愈合时间4~7个月。末次随访时,膝关节活动度范围:伸直-3°~0°,屈曲95°~135°;采用Rasmussen评分标准评价疗效:优19例,良8例,可3例。结论双钢板结合克氏针内固定治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折复位满意、固定牢靠,能够早期行膝关节功能锻炼,骨折端愈合良好,可有效地减少并发症。

Objective To investigate the effect of double plates combined with Kirschner wire in the treatment of Schatzker typeⅤandⅥtibial plateau fractures.Methods Thirty cases of Schatzker typeⅤandⅥtibial plateau fractures were performed with double plates combined with Kirschner wire.Principle of early mobilization and gradually weight-bearing were performed to guide functional training exercise of knee in all patients after operation.Healing of incision,healing of fracture,range of knee joint activities were recorded.Rasmussen score was used to evaluate the clinical function outcomes.Results Satisfactory incisions healing was reached in all patients except 2 cases showed red and swollen,a less volume of effusion,and delayed cured after careful dressing change.All patients were followed-up for 12~24 months.Bone union were achieved in all patients in 4~7 months.At the last follow-up,range of motion of knee joint was straight with-3°~0°and flexion with 95°~135°.Rasmussen criteria score showed the results was excellent in 19 cases,good in 8 and fair in 3.Conclusions Double plates combined with Kirschner wire in treatment of Schatzker typeⅤandⅥtibial plateau fractures achieve satisfactory reduction,good joint function and fractures union.This technique effectively reduces complications of Schatzker typeⅤandⅥtibial plateau fractures.