摘要
目的探讨复杂胫骨平台骨折手术治疗的方法及注意要点。方法回顾性分析自2008-04—2011-09诊治的41例复杂胫骨平台骨折（Schatzker分型：Ⅳ型18例,Ⅴ型14例,Ⅵ型9例）。入院后积极做好围手术期的治疗和处理,收集患者各项辅助检查、查体及个人病史等资料,做好术前和术后的病情评估。根据不同的骨折类型及软组织损伤情况,决定手术时机和手术方式,术后早期进行功能锻炼。结果本组41例中除1例放弃手术外,余40例手术切口均愈合。所有患者术后均获得随访13-19（15.80±2.07）个月,无骨折不愈合及内固定断裂情况的发生。取出内固定前疗效根据HSS评分标准评定：优14例,良17例,可2例,差8例,优良率75.6%。结论充分做好复杂胫骨平台骨折围手术期的治疗和处理,权衡骨折和软组织损伤的轻重,正确选择手术时机和内固定方式,以提高疗效。
Objective To investigate the treatment of complex tibial plateau fractures and discuss the factors influencing results and the methods. Methods Clinical data of 43 patients with complex tibial plateau fractures（according to Schatzker type, 18 cases of type Ⅳ, 14 cases of type Ⅴ, 9 cases of typeⅥ） during Apr. 2008 to Sept. 2011 was included. Perioperative treatment and management were well prepared. The patients＇ auxiliary examinations and personal medical history information were collected. The operation timing and operation method were determined according to the status of the fracture types and soft-tissue lesion. After operation, the patients did early functional exercise. Results Forty cases were primarily healed except that 1 case gave up surgery therapy. All cases were followed up for 13-19 months（mean 15.80±2.07 months）, without non-union, breaking of internal fixators or other complications. Fourteen cases had excellent results, 17 good, 2 fair and 8poor according to the Hss evaluation of the knee（HSS） system, with the satisfactory rate was 75.6%. Conclusion According to our experience, accurate perioperative preparation of fractures, reasonable balance between the fracture and soft-tissue lesion, accurately choice of the operation timing and internal fixation method are essential to good effects of complex tibial plateau fractures.
出处
《中国骨与关节损伤杂志》
2014年第10期997-999,共3页
Chinese Journal of Bone and Joint Injury
关键词
复杂胫骨平台骨折
围手术期处理
切开复位
内固定
Complex fractures of tibial plateau
Perioperative treatment
Open reduction
Internal fixation
