天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (10): 1179-1182.doi: 10.11958/j.issn.0253-9896.2015.10.025

• 应用研究 • 上一篇    下一篇

后内侧入路双支撑钢板治疗胫骨平台后柱骨折

  

  1. 天津市第五中心医院骨科 （邮编 300450）
  • 收稿日期:2015-03-05 修回日期:2015-06-25 出版日期:2015-10-15 发布日期:2015-10-22

Clinical application of double support plate via posteromedial approach in the treatment tibial#br# plateau fracture of posterior column

  1. Department of Orthopedic Surgery, the Fifth Central Hospital of Tianjin, Tianjin 300450, China
  • Received:2015-03-05 Revised:2015-06-25 Published:2015-10-15 Online:2015-10-22

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摘要：

摘要: 目的 探讨后内侧入路双支撑钢板治疗胫骨平台后柱骨折的临床疗效。方法 选取行后内侧入路双支
撑钢板治疗闭合性胫骨平台后柱骨折患者 21 例。其中后柱合并外侧柱骨折 4 例， 三柱骨折 17 例。观察术后伤口
愈合情况； 术后 2 周、 3 个月、 4 个月、 6 个月、 12 个月、 末次随访时复查 X 线片， 获得骨折平均愈合时间； 测量对比术
后 2 周与末次随访时胫骨平台内翻角及后倾角变化； 采用 Rasmussen 评分标准评定膝关节功能恢复情况。结果 术
后平均随访 （18.2±1.8） 个月， 无一例发生切口感染， 骨折平均愈合时间 （3.8±0.6） 个月， 术后 2 周与末次随访时胫骨平
台内翻角及后倾角差异无统计学意义。末次随访时膝关节功能按 Rasmussen 评分标准评定： 优 13 例， 良 6 例， 可 2
例， 优良率 90.5%。结论 后内侧入路可同时显露内侧柱、 后柱内侧及外侧部位骨折， 使用双支撑钢板分别固定后柱
内侧及外侧骨折可有效防止复位丢失， 术后膝关节功能恢复良好。

关键词: 胫骨骨折, 骨折固定术, 内, 钢板固定, 后柱, 膝关节功能

Abstract:

Abstract: Objective To observe the clinical effects of double support plate via posteromedial approach in the treat⁃
ment of tibial plateau fracture of posterior column. Methods A total of 21 cases of tibial plateau fracture in closed posterior
column with an average age of 34.6 (range, 21 to 56) years old were treated using double support plate through posteromedial
approach from January in 2010 to January in 2013（16 males and 5 females） . Among all, 4 cases were combined with lateral
column fracture and 17 cases were three column fracture. Wound healings were observed after operation. X-ray examina⁃
tions were performed at 2 weeks, 3 months, 4 months, 6 months and 12 months after operation as well as at last follow up.
The averaged healing time was calculated. Changes of tibial plateau angle and posterior slope angle were compared between
time points at 2 weeks after operation and at last follow up. Rasmussen knee score criteria was employed to assess knee joint
recovery. Results The mean follow-up was (18.2±1.8) months. No infection was reported. The average fracture healing
time was 3.8（3.8±0.6）months. There was no significant difference between tibia plateau angle and posterior slope angle be⁃
tween time points at 2 weeks after operation and at last follow-up (P < 0.05). According to Rasmussen knee score criteria at
last follow-up, 13 cases were graded as excellent, 6 cases as good, and 2 case as fair, with an excellent and good rate of
90.5%. Conclusion With posteromedial approach, the fractures of medial column, posteromedial and posterolateral of pos⁃
terial column can be exposed well. Using double support plates to fix posteromedial and posterolateral of posterior column
fracture can effectively prevent loss of reduction and the function of knee recovered well postoperatively.

Key words: tibia fractures, fracture fixation, internal, plate fixation, posterior approach, knee function