解剖钢板在胫骨平台骨折治疗中的作用.docVIP

解剖钢板在胫骨平台骨折治疗中的作用 　　作者：王涛 作者单位：志丹县人民医院，陕西 志丹 717500 　　【摘要】 目的：探讨解剖钢板内固定治疗胫骨平台骨折的手术方法及疗效。方法：对2001年6月至2004年6月收治胫骨平台骨折46例进行回顾性，男38例，女8例，左侧33例，右13例。按Schaezker分类方法分型：Ⅲ型17例，Ⅳ型15例,Ⅴ型9例，Ⅵ型5例。根据分型的不同决定手术方式。Ⅲ型骨折行切开复位植骨MAY解剖钢板内固定，Ⅳ型、Ⅴ型、Ⅵ型骨折行切开复位植骨MAY解剖钢板加螺栓、螺钉内固定。结果：46例患者均获随访，随访时间18个月～48个月，平均24个月。按Merchant评分标准，优28例，良10例，中5例，差3例，优良率82.6%。结论：解剖钢板是胫骨平台骨折可靠的内固定。同种异体骨植骨治疗能获得较好的骨性愈合。合并韧带半月板损伤应及时处理，早期行CPM功能锻炼有助于膝关节功能的恢复。 　　【关键词】 胫骨平台骨折 外科手术 回顾性研究 　　The Function of Anatomic Plate in Treatment of Tibial Plateau Fracture 　　WANG Tao,PENG Jiafu 　　(The Peoples Hospital of Zhidan,Zhidan,Shaanxi 717500,China) 　　Abstract :Objective To explore the operative method and clinical outcomes for treating the tibia plateau fracture with anatomic plate at the proximal end of tibia. Methods From june 2001 to june 2004,46 patients (38 male,8 fernale;33 left,13 right) with the tibial plateau fracture were treated by open reduction and internal fixation.According to the Schatzker classification, there were 17 cases of type III,15 cases of type IV, 9 cases of type V, 5cases of type VI . Based on the different type, different operative procedures were selected. Patients of type III were treated by open reduction, bone graft and fixation of MAY anatomic plate. Patients of type IV,V,VI were treated by open reduction, fixation of MAY anatomic plate and lag screw . Results All patients were followed up for an average time of 24 months (from 18 to 48 months) . According to the merchant score ,the result were excellent in 28 cases,good in 10 cases,normal in 5 cases, poor in 3 cases. The excellent in 28 cases, goodrate was 82.6 percent .Conclusion Anatomic plate is a kind of reliable internal fixation in the tibial plateau fracture . Allograft was good for the bone defects . The injuries of ligament and meniscus should be treaed in time . It is helpful for the function recovery of the knee joint with CPM exercise early. 　　Key words:Tibial plateau fractures; Surgical operation; Retrosp