多轴锁定钢板在胫骨平台骨折治疗中的初步应用_临床医学论文.docVIP

多轴锁定钢板在胫骨平台骨折治疗中的初步应用_临床医学论文 多轴锁定钢板在胫骨平台骨折治疗中的初步应用_临床医学论文 作者：郭永飞，刘岩，陈爱民，赵良瑜，欧阳跃平，张伟，苟三怀，侯春林 【摘要】 ［目的］报告多轴锁定钢板治疗胫骨平台骨折的方法及初步临床疗效。［方法］2006年7月-2007年8月，采用开放复位、多轴锁定钢板内固定治疗胫骨平台骨折38例，其中男26例，女12例；年龄18～65 岁，平均30.6岁；闭合性骨折34例，开放性骨折4例。骨折分型采用Schatzker法，Ⅰ型3例，Ⅱ型5例，Ⅲ型5例，Ⅳ型6例，Ⅴ型16例，Ⅵ型3例。术后随访7～18个月，平均13.7个月，根据影像学检查结果及HSS评分标准进行临床效果评定。［结果］所有病例3～6个月后均骨性愈合，术后半年膝关节HSS评分78～98分，平均92.8分，Ⅴ型及Ⅵ型骨折中发生皮瓣坏死1例、切口局部感染1例，所有患者无内固定松动、断裂或骨折复位丢失现象。［结论］胫骨平台多轴锁定钢板操作简便，锁定螺钉植入角度选择性高，内固定稳定性好，避免了原始及继发复位的丢失，是手术治疗胫骨平台骨折安全、有效的内固定方法。 【关键词】 多轴锁定钢板； 胫骨平台骨折； 内固定； Schatzker分型 Abstract：［Objective］To report the polyaxial locking plate and its primary clinical results in the treatment of the tibial plateau fractures.［Method］From July 2006 to August 2007,38 patients with tibial plateau fractures,including 26 males and 12 females,were treated with surgical reduction and internal fixation with polyaxial locking plate.The mean age of the patients was 30.6 years (18-65 years).According to Schatzker classification,there were 3 of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,6 of type Ⅳ,16 of type Ⅴ,3 of type Ⅵ,of which 34 were closed fractures and 4 open fractures.The followup period ranged from 7 to 18 months with a mean of 13.7 months.Function of the knees were assessed according to HSS system and radiological examination.［Result］Solid arthrodesis were obtained in all patients at 3-6 months after operation.Skin flap necrosis and incision infection happened respectively in 2 cases of type Ⅴ and type Ⅵ fractures.The score of HSS system was 92.8(range 78-98) averagely half year after operation and no reduction loss was observed.［Conclusion］The polyaxial locking plate is an effective fixation technique for the surgical treatment of the tibial plateau fractures because of its convenience and stability.The locking screws can be implanted in various directions and reduction loss is avoided postoperation. Key words：polyaxial locking plate; tibial plateau fractures; internal fixation; Schatzker classification 胫骨平台骨折系临床上常见骨折类型之一。随着我国社会老龄化的加速、