胫骨中下段后路手术的解剖学基础及临床应用

Anatomy Base and Clinical Application of Posterior Approach for Surgical Treatment of Middle and Distal Part of Tibia

目的 探讨胫骨中下段骨折伴前侧软组织严重损伤患者的手术入路及固定方法。方法 观测60例胫骨标本后面形态及横径值,并与矩形加压钢板宽度进行比较。结果 胫骨后面自滋养孔以下至内踝上5cm较扁平宽阔,长16.88±1.40cm,其上段横径2.05±0.22cm,中段横径1.86±0.19cm,下段横径2.39±0.26cm。胫骨中下段后面形态适合矩形钢板内固定,临床应用36例,骨折愈合率达94.44％。结论 胫骨中下段骨折伴前侧严重软组织损伤的病例,采用后路钢板内固定是其很好的手术适应证。

Objective To research the surgical approach and fixed method of middle and distal part of tibia fracture while its anterior soft-tissues were injured seriously. Methods Thirty-six cases of tibien specimen were investigated their posterior shape and widths as compared with rectangle pressor plate. Results Tibien posterier from nutrient foramen to medial malleolar upper 5cm were flat and broad. The length was 16.88 ± 1.40 cm. The widths of upper segment, midpiece, and lower segment were 2.05 ± 0.22 cm, 1.86 ± 0.19 cm, and 2.39 ± 0.26 cm, individually. The posterior shape of middle and distal part of tibia filed internal fixation of rectangle steel plate. We have been used 36 cases in the clinic. The healing rate was 94.44%. Conclusion It is surgical indication that using posterior approach plate is fixed in the middle and distal part of tibia fracture while its anterior soft-tissues were injured seriously.