摘要
背景:Schatzker Ⅴ、Ⅵ型胫骨平台骨折多为高能量损伤,常伴有严重的软组织损伤,关节面塌陷,胫骨髁分离,如不能选择合适的时机,采取合理的手术治疗方案,则易出现软组织并发症及膝关节功能障碍。目的目的:探讨应用外固定架与切开复位双接骨板内固定分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折的临床效果。方法方法:回顾分析2011年6月至2015年6月治疗的23例Schatzker Ⅴ、Ⅵ型胫骨平台骨折患者的临床病例资料。男19例,女4例;年龄36~68岁,平均46.5岁;入院时间为伤后4 h^3 d,平均1.3 d。采用Ⅰ期跨关节组合式外固定架撑开,1~3周后Ⅱ期拆除外架切开复位双接骨板螺丝钉内固定治疗。结果结果:随访10~24个月,平均15个月,所有患者骨折全部愈合,平均愈合时间4.7个月,无伤口感染及皮肤坏死等软组织并发症。根据末次随访结果采用Rasmussen评分评定膝关节功能:优11例、良8例、可4例。结论结论:外固定架与切开复位双接骨板内固定分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折,软组织并发症少,固定牢固,可早期膝关节功能锻炼,膝关节功能恢复满意,是治疗高能量所致胫骨平台骨折的有效方法。
Background： Schatzker type V,VI tibial plateau fractures are always high-energy injury,and often accompanied by severe soft tissue injury,joint surface subsidence and tibial condyle separation. Once appropriate timing and reasonable surgical treatment miss,soft tissue complications and knee joint dysfunction will appear. Objective： To investigate the clinical effect of staged treatment by external fixation and open reduction with double plate internal fixation for Schatzker type V,VI tibial plateau fractures. Methods： Clinical data of 23 patients with Schatzker type V,VI tibial plateau fractures treated from June 2011 to June 2015 were retrospectively analyzed. There were 19 males and 4 females with an average age of 46.5years（range,36-68 years）. The mean duration from injury to admission was 1.3 d（range,4 h-3 d）. All the patients were treated by modular trans-joint external fixator on one-stage,and the external fixator was removed and open reduction and internal fixation with double plate screw was used after 2-3 weeks. Results： The average duration of follow-up was 15 months（range,10-24 months）. All the fractures were healed,and the average healing time was 4.7 months. No wound infection or necrosis happened. According to the Rasmussen criteria for knee joint function at the last follow-up,the result was excellent in 11 cases,good in 8 cases,and fair in 4 cases. Conclusions： The staged treatment（external fixation followed by open reduction and double plate internal fixation） has the advantages of less soft tissue complications,firm fixation,early functional exercise of knee joint and satisfactory knee joint function recovery for Schatzker type V,VI tibial plateau fractures. It is an effective method in the treatment of fracture of tibial plateau caused by high energy injury.
出处
《中国骨与关节外科》
2016年第6期508-511,共4页
Chinese Journal of Bone and Joint Surgery
