胫骨平台骨折治疗效果评估.docVIP

胫骨平台骨折治疗效果评估 　【摘要】 总结治疗胫骨平台骨折的疗效，为临床选择治疗胫骨平台骨折的最佳方案。［方法］本组总结本科于1999年1月～2003年1月治疗138例胫骨平台骨折，均为外伤后2周内的新鲜骨折，男79例，女59例，年龄15～76岁，平均43.5岁，合并膝关节韧带及半月板损伤95例。按AO分型和塌陷程度分为B、C两种类型，B1、B2型骨折主要采用手法整复骨牵引、小夹板外固定；B3、C1型骨折主要采用撬拔复位、植骨后螺丝钉内固定；C2、C3型骨折主要采用钢板坚强内固定。［结果］138例胫骨平台骨折133例获得随访，随访时间6～36个月，平均23个月。膝关节功能恢复按KDLMERT标准，B1、B2、B3型优良率为100％，C1型骨折优良14例，可2例；C2型骨折优良10例，可8例；C型骨折优良6例，可3例，差2例。膝关节功能优良者118例(88.7％)，可、差者15例(11.3％)。［结论］胫骨平台骨折的治疗应以关节面损伤程度为重点，早期膝关节功能锻炼能获得满意的治疗效果。 【关键词】 胫骨平台 骨折 AO分型 Abstract：［Objective］To summarize efficiency evaluation of treatment for tibial plateau fracture，to select optimal treatment for tibial plateau fracture in clinical practice.［Method］Retrospective analysis of 138 patients of tibial plateau fracture in our hospital from January 1999 to January 2003.They were all fresh fracture within 2 weeks after trauma，79 cases male 59 cases female，age 15～76,average 43.5 yrs.95 cases complicated with ligament and meniscus injure in knee joint .according to B 1，B2 were treat with manipulative reduction，traction AO classification and sinking degree，they were divided into type B and type C.type and external fixation of splint.Type B3，C1 were treated with prizeup replacement，grafting and internal fixation with screws.Type C2,C3 were treated with firm internal plate fixation.［Result］133 cases were followed up for 6～36months in 138 cases of tibial plateau fracture，average 23 months. Recovery of knee function were divided according to KDLMERI classification . Type B1B2B3 excellent rate 100%. C1 excellent 14cases ，fair 2 cases .C2 excellent 10 cases，fair 8 cases .C3 excellent 6cases，fair 3 cases，badly 2 cases.Recovery of knee fruction excellent 118 cases (88.7%), fair and spoor 15cases (11.3%).［Conclusion］sinking degree of articular surface must be emphasized in treatment oftibial plateau fracture. Satisfied therapy effect can be obtained with early function exercise of knee joint. Key words：tibial plateau; fracture; AO classification 胫骨平台骨折是一种比较常见的关节内复杂骨折，骨折后产生特殊的生物力学特点，治疗不当将产