[精品]翻转体位前后联合入路治疗复杂胫骨平台骨折.doc

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1、翻转体位前后联合入路治疗复杂胫骨平台骨折翻转体位前后联合入路治疗复杂胫骨平台骨折【摘耍】目的探讨翻转体位前后联合入路治疗复杂胫骨平台骨折的手术体位、手术入路、手术方法和临床疗效。方法冋顾性分析采用翻转体位前后联合入路治疗且随访完整的15例复朵胫骨平台骨折患者的临床资料。均采用翻转体位后内侧倒“1〃形入路联合前外侧入路行钢板螺钉内固定，关节而塌陷者采用同种异体骨或自体翳骨植骨术。结果所有患者获得随访，随访时间8〜24个月，平均随访16.3个月，全部病例获得影像学上的骨性愈合，愈合时间16〜26周，平均愈合时间20周。术中未出现血管

2、、神经损伤，术后无内固定松动及断裂，术后1例出现浅表伤口感染。术后末次随访Rasmussen膝关节功能评分为15〜28分，平均24.3分，其中优6例，良7例，可2例，优良率86.7%o术后末次随访Rasmussen放射学评分12〜18分，平均评分16.7分，其中优9例，良5例，可1例，优良率93.3%o结论对于涉及后方平台的复杂胫骨平台三柱骨折，翻转体位前后侧联合入路可以很好地暴露骨折块，复位良好，并发症少，近期取得满意疗效。【关键词】胫骨骨折；翻转体位；手术入路【Abstract】ObjectiveToinvestigatet

3、heoperativeposition,operativeapproach,operativemethodandclinicaleffectofposteromedialandanterolateralapproachesinflippingsupinepositioninthetreatmentofcomplextibialplateaufractures・MethodsTheclinicaldataof15casesofcomplextibialplateaufracture,whichunderwentthetreatme

4、ntofposteromedialandanterolateralapproachesinflippingsupinepositionwithcompletedfollow-up,wereretrospectivelyanalyzed・Al1casesweretreatedbyposteromedialconverse"L"approachandanterolateralapproachinflippingsupinepositionwithsteelscrewinternalfixation.Allograftboneorau

5、togenousiliacbonetransplantationwereconductedforarticularsurfacecollapse・ResultsAllthecaseswerefollowedupfor8to24months,andtheaveragetimewere16.3months・Allcaseshadimagingboneunionwiththehealingtimerangedfrom16to26weeks,andtheaveragetimewas20weeks・Therewerenointraoper

6、ativebloodvesselornerveinjuriesandpostoperativeinternalfixationlooseningorbreakageoccurred,while1caseofpostoperativesuperficialwoundinfectionappeared・Rasmussenkneefunctionscoreinthelastfollow-upwas15~28pointswithanaveragescoreas24.3points,andtherewere6excellentcases,

7、7goodcasesand2faircaseswiththegoodrateas86.7%.PostoperativeRasmussenradiologicscoreinthelastfollow-upwas12~18pointswithanaveragescoreas16.7points・Therewere9excellentcases,5goodcasesand1faircasewiththegoodrateas93.3%.ConclusionPosteromedialandanterolateralapproachesin

8、flippingsupinepositionoftreatingcomplextibialplateaufracturescanexposethefracturesblockwithgoodfixationandlesscomplication,anditssh