摘要
背景:复杂胫骨平台骨折常合并周围软组织损伤,切开复位内固定损伤大,微创外固定技术或许有利于降低并发症。目的:评估环形外固定治疗复杂胫骨平台骨折的临床疗效及并发症。方法:选取2009年2月至2013年2月,采用环形外固定治疗复杂胫骨平台骨折,且随访资料完整者34例,按Schatzker骨折分型,Ⅴ型19例,Ⅵ型15例。记录手术时间、下床活动时间、完全负重时间、末次随访时膝关节功能(Rasmussen评分)。结果:所有患者均完成随访,时间24~68个月,平均(35.2±18.7)个月;手术时间45~75 min,平均(64.8±13.2)min;下床活动时间1~4 d,平均(3.1±0.8)d;完全负重时间3~5个月,平均(3.6±1.7)个月。随访期出现钉道感染者5例(11.8%),通过伤口护理、口服抗生素治愈;无患者并发皮肤坏死、深部感染、骨髓炎;末次随访时,无患者发生骨不连;骨折愈合时间4~7个月,平均(5.1±2.3)个月;Rasmussen评分16~28分,平均(25.9±11.4)分,优良率88.2%。结论:采用环形外固定治疗复杂胫骨平台骨折,可获得满意的临床疗效,并有手术创伤小、骨折愈合快、软组织并发症少等优点。
Background： Because complex tibial plateau fracture is often complicated with surrounding soft tissue injury,minimally invasive external fixation may be less harmful than open reduction and internal fixation. Objective： To analyze the clinical outcomes and complications of circular external fixation in treatment of complex tibial plateau fracture. Methods： A total of 34 patients with complex tibial plateau fracture, who were treated by circular external fixation from February2009 to February 2013 and had complete follow up, were enrolled in this study. There were 19 cases of Schatzker type Ⅴand 15 cases of type Ⅵ. Operation time, ambulation time, full weight-bearing time and knee function（Rasmussen score） at final follow-up were recorded. Results： All of 34 patients were followed up for 24-68 months with（35.2±18.7） months as mean. Mean operation time, ambulation time and full weight-bearing time were（64.8±13.2） min（range, 45-75 min）,（3.1±0.8） d（range, 1-4 d） and（3.6 ± 1.7） months（range, 3-5 months）, respectively. Pin track infection occurred in 5 patients（11.8%） treated by wound care and oral antibiotics. None had skin necrosis, deep infection, osteomyelitis or nonunion. The mean fracture healing time was（5.1±2.3） months（range, 4-7 months）, and Rasmussen score was 25.9±11.4（range, 16-28）.The excellent and good rate was 88.2%. Conclusions： Circular external fixation has satisfactory clinical effect on complex tibial plateau fracture, with the advantages of less invasive operation, shorter time for fracture union and lower incidence of soft tissue complications.
出处
《中国骨与关节外科》
2017年第3期240-242,共3页
Chinese Journal of Bone and Joint Surgery
关键词
胫骨平台骨折
外固定支架
疗效
并发症
Tibial Plateau Fracture
External Fixation
Effect
Complication
