摘要
目的 探讨一种新型胫骨平台后外侧柱万向锁定解剖板(以下简称“新型万向锁定解剖板”)治疗胫骨平台后外侧柱骨折的临床疗效。方法 回顾分析2020年10月—2021年12月应用新型万向锁定解剖板治疗的14例胫骨平台后外侧柱骨折患者临床资料。其中男7例,女7例;年龄29~75岁,平均59岁。左侧5例,右侧9例。致伤原因:高处坠落伤5例,交通事故伤7例,其他伤2例。受伤至手术时间3~10 d,平均6 d。Schatzker分型:Ⅱ型4例,Ⅴ型8例,Ⅵ型2例;骨折均累及胫骨后外侧平台。三柱分型:双柱(前外侧柱+后侧柱)4例,三柱10例。记录手术时间、术中出血量、骨折愈合及并发症发生情况;采用Rasmussen放射学评分标准评估胫骨平台骨折复位情况,美国特种外科医院(HSS)评分标准评估膝关节功能恢复情况。结果 14例患者均顺利完成手术,手术时间95~180 min,平均154 min;术中出血量100~480 mL,平均260 mL。患者均获随访,随访时间6~19个月,平均12.5个月。骨折均愈合,愈合时间15~24周,平均18.7周。随访期间出现1例腓总神经麻痹,1例创伤性骨关节炎,未出现血管损伤、切口感染、下肢深静脉血栓形成、异位骨化、骨不连、内固定物失效等其他并发症。术后即刻胫骨平台骨折复位良好,Rasmussen放射学评分为10~18分,平均15.7分;其中优3例,良10例,可1例,优良率92.9%。术后3个月和末次随访时HSS评分及等级较术前显著改善,差异有统计学意义(P<0.05);术后3个月和末次随访间差异无统计学意义(P>0.05)。结论 对于累及胫骨平台后外侧柱的骨折,新型万向锁定解剖板可提供坚强固定,术后骨折复位满意,膝关节功能恢复良好。
Objective To investigate the effectiveness of a new tibial plateau posterolateral column universal locking anatomical plate(hereinafter referred to as “new universal locking anatomical plate”) in the treatment of tibial plateau posterolateral column fractures.Methods Between October 2020 and December 2021,14 patients with tibial plateau posterolateral column fracture were treated with a new universal locking anatomical plate.There were 7 males and 7 females with an average age of 59 years ranging from 29 to 75 years.There were 5 cases on the left side and 9 cases on the right side.The causes of injury included falling from height in 5 cases,traffic accident in 7 cases,and other injuries in 2 cases.The time from injury to operation ranged from 3 to 10 days,with an average of 6 days.According to Schatzker classification,there were 4 cases of type Ⅱ,8 cases of type Ⅴ,and 2 cases of type Ⅵ.All fractures involved the posterolateral tibial plateau.Three column classification:two columns(anterolateral column+posterior column) in 4 cases,three columns in 10 cases.The operation time,intraoperative blood loss,fracture healing,and complications were recorded.The reduction of tibial plateau fracture was evaluated by Rasmussen radiographic score,and the recovery of knee function was evaluated by Hospital for Special Surgery(HSS) score.Results All 14 cases completed the operation successfully.The operation time was 95-180 minutes,with an average of 154 minutes,and the intraoperative blood loss was 100-480 mL,with an average of 260 mL.All patients were followed up 6-19 months,with an average of 12.5 months.All fractures healed,and the healing time was 15-24 weeks,with an average of 18.7 weeks.During the follow-up,there was 1 case of common peroneal nerve palsy and 1 case of traumatic osteoarthritis.There was no other complication such as vascular injury,incision infection,deep venous thrombosis of lower limbs,heterotopic ossification,bone nonunion,and failure of internal fixation.The reduction of tibial plateau fractures was good immediately after operation,and the Rasmussen radiological score was 10-18,with an average of 15.7;3 cases were excellent,10 cases were good,and 1 case was fair,with an excellent and good rate of 92.9%.The scores and grades of HSS at 3 months after operation and at last follow-up significantly improved when compared with those before operation(P<0.05).There was no significant difference between 3 months after operation and last follow-up(P>0.05).Conclusion For the fractures involving the posterolateral column of the tibial plateau,the new universal locking anatomical plate can provide strong fixation,satisfactory postoperative fracture reduction,and good recovery of knee function.
作者
蓝文彬
林培森
王发圣
吴贵
邱耀宇
谢昀
LAN Wenbin;LIN Peisen;WANG Fasheng;WU Gui;QIU Yaoyu;XIE Yun(Department of Orthopedic Trauma&Ankle Surgery,Fujian Trauma Medical Center,First Affiliated Hospital of Fujian Medical University,Fuzhou Fujian,350004,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2022年第11期1351-1356,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
福建省科技创新联合资金项目(2018Y9078)
中国工程院院地合作项目(2021-FJ-XY-3)
福建省教育厅中青年教师教育科研项目(JAT190199)。
关键词
胫骨平台骨折
后外侧柱
切开复位
内固定
新型万向锁定解剖板
Tibial plateau fracture
posterolateral column
open reduction
internal fixation
universal locking anatomical plate
