外固定架与双接骨板分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折的临床效果分析

发布时间：2017-12-28 19:13

本文关键词：外固定架与双接骨板分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折的临床效果分析　出处：《中华骨与关节外科杂志》2016年06期 　论文类型：期刊论文

【摘要】：背景:Schatzker Ⅴ、Ⅵ型胫骨平台骨折多为高能量损伤,常伴有严重的软组织损伤,关节面塌陷,胫骨髁分离,如不能选择合适的时机,采取合理的手术治疗方案,则易出现软组织并发症及膝关节功能障碍。目的目的:探讨应用外固定架与切开复位双接骨板内固定分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折的临床效果。方法方法:回顾分析2011年6月至2015年6月治疗的23例Schatzker Ⅴ、Ⅵ型胫骨平台骨折患者的临床病例资料。男19例,女4例;年龄36~68岁,平均46.5岁;入院时间为伤后4 h~3 d,平均1.3 d。采用Ⅰ期跨关节组合式外固定架撑开,1~3周后Ⅱ期拆除外架切开复位双接骨板螺丝钉内固定治疗。结果结果:随访10~24个月,平均15个月,所有患者骨折全部愈合,平均愈合时间4.7个月,无伤口感染及皮肤坏死等软组织并发症。根据末次随访结果采用Rasmussen评分评定膝关节功能:优11例、良8例、可4例。结论结论:外固定架与切开复位双接骨板内固定分期治疗Schatzker Ⅴ、Ⅵ型胫骨平台骨折,软组织并发症少,固定牢固,可早期膝关节功能锻炼,膝关节功能恢复满意,是治疗高能量所致胫骨平台骨折的有效方法。
[Abstract]:Background: Schatzker V and VI tibial plateau fracture is high energy injury, often accompanied by severe soft tissue injury, articular surface collapse, tibial separation, such as not to choose the right time to take a reasonable surgical treatment, is prone to soft tissue complications and knee joint dysfunction. Objective: To explore the clinical effect of external fixator and open reduction and double plate internal fixation for the treatment of Schatzker V and VI type tibial plateau fractures. Methods: the clinical data of 23 cases of Schatzker V and VI fracture of tibial plateau from June 2011 to June 2015 were reviewed and analyzed. There were 19 males and 4 females, the average age was 36~68 years, the average age was 46.5 years, and the admission time was 4 h~3 d after injury, with an average of 1.3 D. In the second stage of 1~3 weeks, open reduction and internal fixation with double plate screw fixation were used. Results: all patients were followed up for 10~24 months, with an average of 15 months. All fractures healed. The average healing time was 4.7 months. No wound infection or skin necrosis occurred. According to the results of the last follow-up, the function of knee joint was evaluated by Rasmussen score: excellent in 11 cases, good in 8 cases, and in 4 cases. Conclusion: external fixation and open reduction and double plate internal fixation for the treatment of Schatzker stage V and VI tibial plateau fracture, soft tissue complications, firm fixation, early functional exercise of knee joint, knee joint function recovered satisfactorily, is an effective method for the treatment of tibial plateau fracture caused by high energy.
【作者单位】：中国人民解放军第306医院骨科四病区;
【分类号】：R687.3
【正文快照】： 胫骨平台骨折是骨折线累及胫骨近端关节面的胫骨骨折,根据致伤因素可分为低能量损伤和高能量损伤,其中高能量损伤所致的胫骨平台骨折多伴有不同程度的软组织损伤,甚至合并神经血管损伤,治疗不当会出现严重的并发症,影响膝关节功能。随着交通及建筑业的发展,车祸伤、压砸及高空

【相似文献】