摘要
目的探讨三柱理论指导下三柱固定治疗胫骨平台粉碎性骨折的临床疗效。方法回顾性分析2009年1月至2012年12月收治的胫骨平台粉碎性骨折40例患者,男25例,女15例;年龄为29~64岁,平均（36.6±3.1）岁。均为三柱骨折,所有患者采用漂浮体位下三柱固定,平台塌陷处以同种异体骨植入。术后X线片观察骨折复位及愈合程度,评价标准采用美国特种外科医院（hospital for special surgery,HSS）膝评分、Rasmussen胫骨平台骨折复位放射学评分,并观察并发症的发生情况。结果术后随访2年,所有患者术后即刻均得到良好固定,膝关节内翻角和后倾角均得到很好纠正,Rasmussen放射学评分满意,术后与术前比较差异有统计学意义（P〈0.05）。膝关节功能恢复满意,术后2年HSS评分优良率为95%。2例患者出现轻度创伤性关节炎,其他患者无明显并发症。结论采用三柱固定理论有利于胫骨平台粉碎性骨折的临床治疗,主要体现在中期随访中,三柱固定可使骨折获得更好的复位和牢固的固定,安全性较高,值得临床推广。
Objective To investigate the the clinical effect of three-column fixation in the treatment ofcomminuted tibial plateau fracture under the guidance of three-column theory. Methods Forty cases of commi-nuted fracture of tibial plateau from January 2009 to December 2012 were collected, including 25 males, and 15 females with age ranging 29-64 years old（average, 36.6±3.1 years old）. All patients were subjected to three-col-umn fixation, and tibial plateau depression was treated with bone graft. After postoperative follow- up of2 years, fracture reduction and healing were observed by X- ray examination, and HSS score and Rasmussenscore were compared. At the same time the complications were observed. Results The fixation was good, post-operative knee varus angle and dip angle were well corrected, and Rasmussen score was satisfied. There was sig-nificant difference before and after operation（P〈0.05）. Knee joint function was restored. According to HSSscore, the effective rate of knee joint function was 95% at 2nd year postoperation. There were no obvious compli-cations except 2 patients with traumatic arthritis. Conclusion Three-column fixation theory is conducive bene-ficial in clinical treatment of comminuted tibial plateau fracture, mainly in the medium-term follow-up. Three-column fixation can obtain better fracture reduction and stable fixation with high security.
出处
《骨科》
CAS
2016年第2期98-101,共4页
ORTHOPAEDICS
关键词
胫骨
骨折
评价研究
Tibia
Fractures
Evaluation studies
