双切口3至4板固定治疗累及后内侧柱的复杂胫骨平台骨折疗效.docx

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1、双切口3至4板固定治疗累及后内侧柱的复杂胫骨平台骨折疗效分析任戈亮余承保朱玉洲王宗徐贤齐赵鸣淮南新华医院创伤科232052摘要目的探讨双切口3至4块钢板固定治疗累及后内侧柱的SchatzkerV、VI型复杂胫骨平台骨折的临床疗效。方法2013年1月至2015年12月采用前外侧联合后内侧倒L形双切口，外侧1块3.5mm锁定钢板，内侧及后内侧2至3块3.5mm小钢板固定治疗累及后内侧柱的SchatzkerV、VI型复杂胫骨平台骨折患者15例，分析术后复位效果及随访时膝关节功能情况，评估手术临床疗效。结果15例均获随访，随访时间18～30个月，平均24个月。术后

2、骨折复位效果满意，末次随访时复位无丢失，骨折均愈合，膝关节活动度0～135°，平均115°。膝关节功能采用HSS评分标准评定：优10例，良2例，可3例，差0例，优良率80%。结论对于累及后内侧柱的SchatzkerV、VI型复杂胫骨平台骨折，采用双切口，3至4块3.5mm钢板固定，可以获得有效固定，膝关节功能恢复良好，并发症少，疗效满意。关键词胫骨平台骨折；后内侧柱；双切口；内固定；theTreatmentAnalysisofComplexTibialPlateauFracturesInvolvingPosteromedialColumnUsingDoub

3、leIncisionsand3to4PlatesFixationRenGeliangYuChengbaoZhuYuzhouWangZongXuXianqiZhaomingDepartmentofTraumatology,HuainanXinhuaHospital,HuainanCity,AnhuiProv.,China232052AbstractObjectiveToexploretheclinicaleffectsofSchatzkerV,VIcomplextibialplateaufracturesinvolvingposteromedialcolum

4、nusingdoubleincisionsand3to4platesfixation.MethodsWereviewed15patientswithSchatzkerV、VIcomplextibialplateaufracturesinvolvingposteromedialcolumnwhohadbeentreatedfromJanuary2013toDecember2015.TheyweretreatedbyanterolateralapproachcombinedwithposteromedialinverseLshapedapproachandTh

5、efractureswerefixatedbyone3.5mmlockingplateinlateralplus2to33.5mmsmallplatesinmedialandposteromedial.Weanalyzedthereductioneffectsandkneejointsfunctionaftersurgeryandatthetimeoffollow-upandevaluatedtheclinicalefficacyoftheoperation.Results15patientswereallfollowedupwithin18～30mont

6、hes,averaged24monthes.Thereductioneffectsaftersurgeryweresatisfactoryandmaintainedstable.Allfractureswereunionandtherangeofkneejointsmotionwere0～135°(averaged115°)atthetimeofthelatestfollow-up.AccordingtotheHSSscoresatthefinalfollow-up,15patientswererated18asexcellent,2asgood,4asf

7、airandnooneaspoor,givinganaxcellenttogoodrateof80%.Conclusion3to43.5mmplatesthroughanterolateralapproachcombinedwithposteromedialinverseLshapedapproachisafinetreatmentforSchatzkerV、VIcomplextibialplateaufracturesinvolvingposteromedialcolumn,resultingineffectivefixation,satisfactor

8、yfunctionalrecoveryandlimitedcomp