摘要
目的探讨过伸型胫骨平台骨折的临床治疗。方法回顾性分析2013年11月—2017年12月南京医科大学第一附属医院治疗的12例过伸型胫骨平台骨折。其中男性4例,女性8例;年龄24～65岁,平均53.6岁;致伤原因均为道路交通伤。患者采用屈曲位复位,植骨后使用内外侧钢板固定。观察患者术后平台后倾角、美国特种外科医院膝关节功能评分(HSS评分)、关节屈曲度以及并发症情况。结果术后X线片显示均获得解剖复位。术后均无膝关节反曲,患者均得到随访6～18个月,平均9.7个月。骨折愈合时间8～12周,平均10.0周。所有患者术后测量后倾角5°～9°(平均7.9°),术后半年5°～10°(平均7.7°)。HSS评分90～98分(平均93.6分)。术后半年关节屈曲度120°～145°(平均131°),伸直均为0°。术后无一例发生钢板及螺钉断裂现象。结论通过恢复正常后倾角及关节面平整,充分植骨及锁定钢板固定治疗过伸型胫骨平台骨折,效果良好,值得临床推荐。
Objective To discuss the surgical treatment for hyperextension tibial plateau fracture. MethodsTwelve cases of hyperextension tibial plateau fractures were treated from Nov. 2013 to Dec. 2017 in our department. All these fractures were reduced via lateral /medial approach. There were 4 males and 8 females;their age ranged from 24 to 65 years,with an average of 53.6 years;the causes of injuries were road traffic injuries. Patients underwent flexion reduction and were fixed with internal and external plates after bone grafting. The postoperative platform posterior slope,HSS score,joint flexion and complications were observed. ResultsX-ray films showed anatomical reduction after operation. There was no knee recursion after operation,and the patients were followed up for 6-18 months with an average of 9.7 months. The fracture healing time was 8 to 12 weeks,with an average of 10.0 weeks. All patients were measured with a slope angle of 5°-9° after operation(average, 7.9°) and 5°-10° 6 months after operation(average,7.7°). The HSS score was 90 to 98 points (average, 93.6 points). The joint flexion degree was 120°-140°(average, 131°) after half a year,and the straightness was 0°. There was no case of plate or screw breakage after surgery. ConclusionRecovering posterior slope angle and using locking plate after anatomic reduction can achieve satisfactory treatment in hyperextension tibial plateau fracture.
作者
吕天润
洪顾麒
陈群
宋李军
李翔
LV Tian-run;HONG Gu-qi;CHEN Qun;SONG Li-jun;LI Xiang(Department of Traumatic Orthopedics,First Affiliated Hospital of Nanjing Medical University,Nanjing210029,China)
出处
《创伤外科杂志》
2019年第4期252-256,共5页
Journal of Traumatic Surgery
关键词
胫骨平台骨折
过伸损伤
锁定钢板
后倾角
tibial plateau fracture
hyperextension injury
locking plate
posterior slope angle
