摘要
[目的]探讨膝关节后内侧入路手术治疗胫骨平台后侧骨折的手术方法和临床疗效。[方法]采用后内侧手术入路治疗胫骨平台后侧骨折患者42例,后侧柱骨折均采用胫骨平台后内侧入路,累及内、外侧柱者结合外侧入路或/和正中入路。[结果]42例患者均获得随访,骨折均愈合。术后Rasmussen膝关节功能为14～30分,优良率为90.5%;Rasmussen放射学评分为13～18分,优良率为95.2%。术后2例膝关节伸屈活动明显受限,经康复科康复锻炼后改善;4例发生创伤性关节炎,经向关节内注射玻璃酸钠及口服非甾体类药物后疼痛缓解。[结论]膝关节后内侧入路手术治疗胫骨平台后侧骨折,有利于胫骨平台后侧骨折的复位和固定,结合外侧入路或/和正中入路可对胫骨平台三柱骨折进行良好的复位和有效的固定,具有暴露清楚、内固定安放方便、有效及临床疗效好等优点。运用恰当的康复锻炼可取得满意的临床疗效。
[Purpose] Discuss the operation detail and clinical outcome of posteromedial approach for the treatment of posterior tibial plateau fracture.[Method] Forty-two cases were enrolled,of what 24 cases were male while 18 were female.Mean age was（48.76±10.73） years old（29-72 years old）.Spiral CT 3D reconstruction was applied in all the cases.According to Luo congfeng ’s three cloumn theory,Eighteen cases were posterior column fracture,twelve were posterior and medial column fracture,eight were posterior and lateral column fracture and 4 was three cloumn fracture.Posteromedial approach was applied in all the posterior fracture and lateral or middle approach was combined if lateral or medial column was involved.[Result] Mean follow-up period was（20.36±7.21） month（s 6～35months）.The mean Rasmussen knee function score was 25.3（14~ 30）,of what there were 24 excellent cases,fourteen good cases and 4 fair cases.The mean Rasmussen knee radiology score was 16.6（13~18）,of what there were 26 excellent cases,fourteen good cases and 2 fair cases.There were 2 cases had limited knee movement range postoperatively,improved by rehabilitation.While 4 traumatic arthritis cases relieved by NSAID.[Conclusion] Three cloumn theory is of consequence in chooseing approach.Posteromedial approach can provide good exposure in operation,benefit to reduction and fixation.
出处
《浙江中医药大学学报》
CAS
2012年第9期1007-1008,1014,共3页
Journal of Zhejiang Chinese Medical University
关键词
胫骨平台骨折
后侧
三柱
后内侧入路
内固定
tibial plateau fracture
posterior column
three cloumn
posteromedial approach
internal fixation
