摘要
目的 探讨胫骨平台骨折手术治疗的适应证。方法 对 93例治疗后随访 2年以上的胫骨平台骨折患者进行回顾性分析。结果 治疗前影像学评级为Ⅰ级者共 5例 ,均采用非手术治疗 ,优良率为 5 / 5 ;评级为Ⅱ级者共 5 5例 ,其中 2 5例采用非手术治疗 ,优良率为 2 2 / 2 5 ,另外 30例采用手术治疗 ,优良率为 2 8/ 30 ;评级为Ⅲ级者共 33例 ,其中 2例采用非手术治疗 ,疗效均差 ,另外 31例采用手术治疗 ,优良率为 2 3/ 31。治疗后影像学评级为Ⅰ级者 6 2例 ,优良率为 6 2 / 6 2 ;Ⅱ级者 2 8例 ,优良率为16 / 2 8;Ⅲ级者 3例 ,疗效均差。结论 对影像学评级为Ⅰ级者 ,采用非手术治疗 ;对影像学评级为Ⅱ级者 ,根据患者的身体情况可考虑手术治疗 ;对影像学评级为Ⅲ级伴有韧带断裂、半月板损伤的病例均应手术治疗。
Objective To investigate the indications of surgical treatment of the tibial plateau fracture. Methods A retrospective analysis was performed on 93 cases of tibial plateau fracture after more than 2 years follow up. Results 5 cases rated grade Ⅰ photographically before treatment were given non surgical treatment and got 5/5 excellent good results; 25 cases in 55 of grade Ⅱ were given non surgical treatment and got 22/25 excellent good. The others were given surgical treatment and got 28/30 excellent good results; 2 cases in 33 of grade Ⅲ received non surgical treatment and got poor results. The others were given surgical treatment and got 23/31 excellent good results. 62 cases rated grade Ⅰ photographically after treatment got 62/62 excellent good results; 28 cases of grade Ⅱ got 16/28 excellent good results; all cases of grade Ⅲ got bad results. Conclusion Conservative treatment should be taken on the cases of grade Ⅰ, and surgical treatment could be considered for the cases of grade Ⅱ. Absolute operative indications are those of grade Ⅲ, and those with ligaments and meniscus tearing. 3 DCT and photographical grade play an important role in the preoperative planning and postoperative evaluation.
出处
《临床骨科杂志》
2003年第4期321-323,共3页
Journal of Clinical Orthopaedics
关键词
胫骨骨折
骨折分类
tibial fractures
fracture classification
