关节置换术治疗膝骨性关节炎合并胫骨平台骨折

发布时间：2018-03-12 12:24

  本文选题：膝骨性关节炎　切入点：胫骨平台骨折　出处：《中国矫形外科杂志》2017年02期 　论文类型：期刊论文

【摘要】：[目的]探讨人工膝关节置换术治疗膝骨性关节炎合并胫骨平台骨折的临床疗效。[方法]2012年7月~2015年4月收治骨性关节炎合并胫骨平台骨折患者12例,男4例,女8例;年龄60~72岁,平均67.5岁;致伤原因:交通伤8例(66.7%),坠落伤3例(25%),其他伤1例(8.3%)。受伤前均患有中重度骨性关节炎,有不同程度的屈曲内翻畸形。按“三柱理论”分型:后外侧柱骨折9例,外侧柱骨折3例。合并交叉韧带损伤8例,半月板损伤7例,均采用人工膝关节置换进行一次性治疗骨性关节炎合并胫骨平台骨折。随访期间拍摄X线片及记录关节活动度,并按照美国特种外科医院膝关节功能评分法(HSS)对膝关节功能进行评分。[结果]所有患者均获12~26个月随访,平均(20.5±3.1)个月。术后1周、1年的膝关节活动度和HSS评分与术前相比,差异均有统计学意义。术后1年随访时HSS评分:优7例,良3例,一般1例,差1例,优良率83.3%。[结论]人工膝关节置换治疗骨性关节炎合并胫骨平台骨折具有良好的临床疗效,术后患者可以较早下地活动,减少并发症的发生,提高生活质量。
[Abstract]:[objective] to investigate the clinical effect of artificial knee arthroplasty in the treatment of osteoarthritis with tibial plateau fracture. [methods] from July 2012 to April 2015, 12 patients with osteoarthritis complicated with tibial plateau fracture were treated, including 4 males and 8 females. The average age was 67.5 years old, the average age was 67.5 years. The causes of the injury were: traffic injury (8 cases), falling injury (3 cases), falling injury (3 cases), and other injury (1 case). All of them had moderate and severe osteoarthritis before the injury. There were different degrees of flexion varus malformation. According to "three column theory", 9 cases of posterolateral column fracture, 3 cases of lateral column fracture, 8 cases with cruciate ligament injury, 7 cases with meniscus injury. Knee arthroplasty was used to treat osteoarthritis with tibial plateau fracture. All patients were followed up for 12 to 26 months, with an average of 20.5 卤3.1 months. The knee motion and HSS score of 1 year after operation were compared with those before operation. The difference was statistically significant. The HSS score of 1 year follow-up: excellent 7 cases, good 3 cases, average 1 case, poor 1 case, excellent and good rate 83.3%. [conclusion] artificial knee arthroplasty has good clinical effect in treating osteoarthritis with tibial plateau fracture. Postoperative patients can get down early to reduce the incidence of complications and improve the quality of life.
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