三柱分型理论指导下手术治疗复杂胫骨平台骨折的临床疗效分析.pdf

提 要 目的：通过对近2年我院所收治的复杂胫骨平台骨折的病例资料进行分析研究， 总结在三柱分型理论指导下手术治疗复杂胫骨平台骨折的临床经验。 方法：本研究总结了自2010年4月至 2011年10月于山东中医药大学附属医院 骨科就诊，确诊为复杂胫骨平台骨折并在三柱分型理论指导下进行手术方案设计，并 最终接受治疗治疗的29例患者的临床治疗经验，术后随访10～16月，平均随访12 个月。其中，交通事故伤15例，坠落伤9例，重物砸伤4例；Schatzker分型Ⅳ型 5 例，Ⅴ型16例，Ⅵ型8例；男22例，女7例；左侧17例，右侧12例；合并交叉韧 带损伤者8例，半月板损伤者5例，侧副韧带损伤者4例；年龄最大者67岁，最小 者18岁，平均年龄39.5岁；均为单侧骨折；所有患者均根据患肢患处软组织损伤情 况来决定手术时机；术后指导患者进行系统的康复训练，采取必要的措施以预防并发 症的发生。术后1年内对其进行随访，运用HSS评定标准对所收集的数据资料进行评 分，观察疗效。 结果：29例患者中，优21例，良5例，可3例，差0例，优良率为89.7%。 结论：三柱分型理论指导下进行的复杂胫骨平台骨折手术治疗有适应征广、内固 定坚强可靠、术后并发症少、能早期进行功能锻炼、膝关节术后功能恢复良好等优点， 总体疗效满意。 关键词 三柱分型；内固定；复杂胫骨平台骨折；临床疗效观察 The clinical effects analysis of treating complicated tibial plateau fractures under the direction of three column classification theory Specialty: Orthopaedics of TCM Author: Zhang Kaisan Tutor: Prof. Han Ming Abstract Objective: By analyzing data from patients of complicated tibial plateau fractures in the past 2 years, the research will summarize the experiences of treating complicated tibial plateau fractures under the direction of three column classification theory. Methods: In this research, 29 patients with complicated tibial plateau fractures were selected from Shandong university of traditional Chinese medicine hospital between April 2010 and October 2011. All patients were operated under the direction of three column classification theory and followed up for 10-16 months, an average of 12 months. According to types of injury: traffic accident injury in 15 cases, falling injury in 9 cases, heavy weight injury in 4 cases. According to Schatzker classification: type Ⅳin 5 cases, type Ⅴin 16 cases and typeⅥ in 8 cases. According to damage location types, cruciate ligament injury in 8 cases, meniscus injury in 5 cases, col