胫骨平台骨折Schatzker分型对膝关节功能的影响研究

Study on the Influence of Schatzker Classification of Tibial Plateau Fracture on Knee Joint Function

选取庆阳市人民医院2016年1月—2017年6月收治的124例胫骨平台骨折患者为研究对象,术前均行胫骨平台X线和CT检查,以明确骨折类型。依据Schatzker分型将其分为Ⅰ~Ⅵ6种不同类型,根据分型确定手术治疗方案。所有患者均随访1~2年,平均16个月,评价其膝关节功能,比较各分型患者术后膝关节功能恢复情况并分析其原因。结果显示SchatzkerⅠ、Ⅱ型膝关节功能评分与SchatzkerⅤ、Ⅵ型有明显差异(P<0.05),SchatzkerⅤ、Ⅵ型膝关节功能恢复较差。Mann-Whitney U检验结果显示SchatzkerⅠ、Ⅱ型分别与SchatzkerⅤ、Ⅵ型比较,差异均有统计学意义(P<0.05)。研究结果表明SchatzkerⅤ、Ⅵ型胫骨平台骨折属复杂性胫骨平台骨折,多累及胫骨内外髁及关节面,对膝关节功能的影响程度大于其他分型;应结合胫骨平台骨折损伤程度及Schatzker分型制定个体化的关节功能康复锻炼方案,以促进膝关节功能恢复。

This article selected 124 cases of patients with fracture of tibial platform treated in Qingyang People's Hospital from January 2016 to June 2017 as the research object.Schatzker classification will be divided intoⅠ~Ⅵsix different types according to the classification to determine treatment plan.All patients were followed up for 1 to 2 years,with an average of 16 months.The knee joint function of the affected side was evaluated,and the postoperation knee joint function recovery of each type of patients was compared and the causes were analyzed.SchatzkerⅠ,Ⅱknee function score and SchatzkerⅤ,Ⅵmodel have obvious difference(P<0.05),and SchatzkerⅤ,Ⅵknee functional recovery was poor.The Mann-Whitney U test results show that the SchatzkerⅠ,Ⅱare respectively campared with SchatzkerⅤ,Ⅵ,and the difference had statistical significance(P<0.05).SchatzkerⅤ,Ⅵtype belongs to the complex fractures of tibial plateau fracture,many involving external ankle and joint surface in the tibia,which have greater effect on knee joint function than other classifications.In order to promote the recovery of knee joint function,individualized rehabilitation and exercise programs should be developed based on the injury degree of tibial plateau fracture and Schatzker classification.