胫骨平台骨折52例临床分析

Clinical analysis of the treatment of 52 tibial plateau fractures

目的比较胫骨平台骨折的几种治疗方法,选择治疗胫骨平台骨折的最佳方案。方法本组总结胫骨平台骨折52例,按AO分型和塌陷程度分为B、C两种类型。B1、B2型骨折主要采用手法整复骨牵引或石膏外固定;B3、C1型骨折主要采用撬拨复位,植骨后采用松质骨螺钉固定;C2、、C3型骨折主要采用坚强固定。结果52例胫骨平台骨折获得随访47例,膝关节功能恢复按关节功能、活动范围、膝关节轴线、关节稳定性及骨折复位综合评定,膝关节功能优良者41例(87.24%),可及差6例(12.76%)。结论胫骨平台骨折的治疗应以关节面损伤程度为中心,选择恰当的治疗方案,早期膝关节功能练习能够获得满意的治疗效果。

Objective To compare the therapeutic effects of several trea tments of the tibial plateau fracture. Methods According to AO classification an d their depressed degrees,52 cases of tibial plateau fractures were classified into types B and types C. Types B1 and B2 were treated with manipulative tractio n and bone traction or cast external fixation; Types B3 and C1 with bone graft a nd screw fixation after reduction operation; Types C2 and C3 with fixation by pl ates. 47 cases were followed up for 6 to 48 months. Results In 41 cases the reco very of knee function was excellent (87.24%), whereas the recovery was poor in 6 cases (12.76%).Conclusion The joint surface should be the focus of attention and care in the treatment of the tibial plateau fracture and a satisfactory ther apeutic result could be attained by early post-surgical exercise.