后内侧入路Ⅲ型中T型锁定板内固定治疗胫骨平台后外侧骨折

The typeⅢmedium locking T-shaped plate for treatment of tibial plateau posterolateral fracture with posteromedial approach

目的探讨后内侧入路Ⅲ型中T型锁定板内固定治疗胫骨平台后外侧骨折的疗效。方法采用后内侧入路Ⅲ型中T型锁定板内固定治疗19例胫骨平台后外侧骨折患者。术后10个月采用Rasmussen骨折复位解剖学评分标准来评价骨折复位质量,末次随访时采用HSS评分评价膝关节功能。结果患者均获得随访,时间10~24个月。骨折均愈合,时间12~15周。术后均未发生内固定松动、关节面塌陷、力线丢失、切口深部感染及创伤性关节炎等并发症。术后1例由于肥胖原因关节屈伸锻炼不配合,活动度受限,加用CPM机锻炼后明显好转。术后10个月,采用Rasmussen骨折复位解剖学评分标准评价骨折复位质量:优15例,良4例;膝关节屈曲为110°~135°。末次随访时采用HSS评分评价膝关节功能:优11例,良7例,可1例,优良率为18/19。结论后内侧入路Ⅲ型中T型锁定板内固定治疗胫骨平台后外侧骨折显露充分,有利于骨折解剖复位,疗效良好。

Objective To explore the clinical efficacy of typeⅢmedium locking T-shaped plate for treatment of tibial plateau posterolateral fracture with posteromedial approach.Methods The 19 patients with posterolateral fracture of tibial plateau were treated by typeⅢmedium locking T-shaped plate via posteromedial approach.At 10 months postoperation,Rasmussen fracture reduction anatomical scroe criterion was used to evaluate the fracture reduction quality,and HSS score was used to assess the knee function at the last follow-up.Results All patients were followed up for 10~24 months.Bone healing were attained within 12~15 weeks.After operation,no complications such as internal fixation loosening,articular surface collapse,fracture alignment disorder,incision deep infection and traumatic arthritis were found.In one patient,the joint flexion and extension exercise was not coordinated due to obesity,and the activity was limited,who was obviously improved after exercise with CPM machine.At 10 months postoperation,the fracture reduction quality was excellent in 15 cases,good in 4 cases,according to the Rasmussen score criterion;and the flexion range of knee joint was 110°~135°.At the last follow-up,HSS score assessment result was excellent in 11 cases,good in 7,fair in 1,with the excellent-good rate of 18/19.Conclusions The typeⅢmedium locking T-shaped plate with posteromedial approach for treatment of tibial plateau posterolateral fracture is clear expousre,which is benefit for anatomical reduction,with good effect.