老年人胫骨平台骨折的治疗

Treatment of tibia plateau fracture in senile patients

目的总结老年人胫骨平台骨折手术治疗的临床经验。方法分别用松质骨螺钉、空心加压螺纹钉、L型角钢板、T型支撑钢板内固定35例。结果随访6～12个月,33例X线示骨折愈合无移位,膝关节位置及间隙正常。Merchant评分标准:优22例,良9例,可2例,差2例,优良率为85.7%。结论老年人胫骨平台骨折应早期手术治疗,恢复关节面的平整性,可靠的内固定、植骨解决和防止术后平台塌陷,早期功能锻炼减少后期并发症。

Objective To sum up the clinical experience of operative management of tibia plateau fracture in senile patients. Methods 35 cases of senile tibia plateau fracture were treated with different ways of internal fixation, including screw, cannulated compression screw, L shaped plate, and T shaped plate. Results All the 35 cases were followed up and the time ranged from 6 months to 2 years. X ray films showed that the anatomical reduction was reached and the fractures healed in 33 cases. The final results were rated according to Merchant criteria: excellent in 22 cases, good in 9 cases, fair in 2 cases and poor in 2 cases. The excellent and good rates were 85.7%. Conclusions Operation on senile patients with tibia plateau fracture should be performed early so as to reconstruct the articular surface. Rigid fixation and bone transplantation are impartment means to avoid plateau collapse, and early functional exercise can reduce postoperative complications.