摘要
【目的】探讨胫骨平台骨折术后高度丢失的原因及其对策，提高胫骨平台骨折手术解剖复位率。【方法】对1997年9月至2007年11月本院收治的不同类型胫骨平台骨折患者中临床资料完整并有良好随访的51例进行影像学分析。【结果】51例患者平均随访时间24．8个月（9～54个月），有25．5％发生平台高度丢失（判定标准：关节面塌陷大于5mm和／或轴向对线不良〉5°）。胫骨平台骨折术后高度丢失可能与患者年龄、骨质疏松程度、骨折粉碎与移位程度、内固定方式、植骨情况及功能锻炼与负重时间有关。【结论】胫骨平台骨折术后高度丢失的原因是多方面的综合因素。术前准确判断骨折类型，术中解剖复位后足量植骨、坚强内固定，术后早期不负重功能锻炼是保持平台高度不丢失、提高手术疗效的关键。
[Objective] To investigate the causes of postoperative altitude loss in tibial plateau fracture and provide strategies for improving anatomical reduction rate. [Methods] The radiograms of 51 cases with tibial plateau fracture from September 1997 to November 2007 in our hospital were analyzed. [Results]All the cases vere followed up from 9 to 54 months（24.8 months on average）. The rate of postoperative altitude loss was 25.5 % according to the criteria （the depression of the articular surface was more than 5 millimeters or malalignment of the extremity was more than 5 degrees）. Postoperative altitude loss in tibial plateau fracture was related to age, osteoporosis, preoperative displacement, fracture fragmentation, the style of internal fixation, bone graft and the time of functional exercise and weight loading. [Conclusion]Postoperative altitude loss in tibia plateau fracture is caused by many factors. The key points to avoid altitude loss of plateau and enhance the outcome include precise judgment of the type of fracture before operation, sufficient amount of bone graft after anatomic reduction and rigid internal fixation in operation and an appropriate plan for performing early, non-load and functional exercise after operation.
出处
《医学临床研究》
CAS
2008年第7期1255-1258,共4页
Journal of Clinical Research
