胫骨平台骨折手术疗效影响因素的探讨_医学论文.docVIP

胫骨平台骨折手术疗效影响因素的探讨_医学论文 胫骨平台骨折手术疗效影响因素的探讨_医学论文 作者：王凯，车彪，邹凯，刘俊，覃松【摘要】 ［目的］总结胫骨平台骨折手术治疗的临床结果，分析影响术后疗效的相关因素，探讨有效的防范措施。［方法］回顾分析本院2000年2月～2005年4月收治的107例胫骨平台骨折手术后患者资料，其中，男62例，女45例。骨折类型按Schatzker分型［1］，其中I型2例，Ⅱ型37例，Ⅲ型29例，Ⅳ型22例，V型10例，Ⅵ型7例。除I型2例采用空心加压螺钉固定外，其余均采用开放复位、钢板螺钉内固定、塌陷缺损处自体或同种异体骨植骨。对术后疗效及影响的相关因素进行分析。［结果］107例获得随访，平均随访时间27个月(9～64个月)，功能评价采用Hohl膝关节功能分级系统［2］，临床结果优良率达到85.98％，术后发生明显并发症有9例(关节僵硬1例，创伤性关节炎8例，其中包含关节面重新出现塌陷4例)。［结论］外科手术是治疗胫骨平台骨折十分有效的方法，术中骨折的解剖复位、稳定的内固定、术中尽可能保护和修复附属软组织结构、术后正确的关节功能康复治疗是影响患者术后疗效的主要因素。 【关键词】 胫骨平台； 骨折； 内固定 　　Discussion of influencing factors therapeutic effect in the operative treatment of the fracture of tibial plateau∥ 　　 　　Abstract：［Objective］To evaluate the result of operative treatment of tibial plateau fracture and analyze its related factors of influencing the therapeutic effect and provide effective prevntional measures.［Method］Totally 107 cases(male 62 casesfemale 45 cases) of tibia plateau fractures were operated with internal fixation from Feb. 2000 to Apr. 2005 in our hospital. According to Schatzker classification，there were typeⅠfracture 2 cases，typeⅡ 37 cases，typeⅢ 29 cases，type Ⅳ 22 cases，type Ⅴ 10 cases，type Ⅵ 7cases.TypeⅠfractures were treated with cannulated screws，other type fractures were performed with open reduction and internal fixation with buttress plates and autologous and/or allograft bone grafts. Therapeutic effect and its related factors were analyzed concomitantly.［Result］The 107 patients were followed up for 9～64 months(averaged 27 months).The clinical results were assessed according to Hohl scale for knee joint.The excellent and good results was 85.98%.There were obvious complications articular stiffness 1 cases and traumatic arthritis 8 cases including tibia plateau articular depression 4 cases.［Conclusion］Surgical operation is effective methods of treating tibia plateau fracture， The complete fracture reduction suitable internal fixation a good protection and recovery of the soft tissue of the knee joint structure，an