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《胫骨结节骨折合并胫骨平台骨折采用锁定钢板联合直接钢丝固定解析复习进程.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、胫骨结节骨折合并胫骨平台骨折采用锁定钢板联合直接钢丝固定解析Theauthorsdidnotreceivegrantsoroutsidefundinginsupportoftheirresearchorpreparationofthisarticle.Oneauthor(M.S.V.)hasreceivedanunrestrictededucationalgrantfromSynthesinsupportofhisfellowshipprogram.Alldevicesincludedinthisart
2、icleareFoodDrugAdministrationapproved. PresentationofMaterial:notapplicable. Reprints:MarkS.Vrahas,MD,ChiefofOrthopaedicTrauma,PartnersOrthopaedics,AssociateProfessor,HarvardSchoolofMedicine,MassachusettsGeneralHospital,55FruitSt,YAW3600-3C,Boston,MA0211
3、4.SummaryTibialtuberclefracturesdisruptingtheextensormechanismofthekneecanoccurinassociationwithcomplextibialplateaufractures(AOtype41A,B,C).Themanagementofthesefracturescanbedifficult;astablerepairofthetibialtuberclefragmentisessentialiftheextensormecha
4、nismistobereconstituted.Therearefewreportedtechniquesdescribedtomanagetibialtuberclefracturesinconjunctionwithcomplexproximaltibialinjuries.Traditionally,tibialtuberclefractureshavebeenrepairedbylaggingthetuberclefragmenttotheposteriorcortexofthetibiausi
5、ng1ormorescrews.However,thecortexoftheposteriortibiadoesnotalwaysoffergoodpurchaseforscrewfixation,particularlyinosteopenicbone.Additionally,incomplexproximaltibialfractures,comminutionoftenextendsposteriorly,furthercomplicatingstablelagscrewfixation.Pla
6、cementofananteroposteriorlagscrewcanalsobecomplicatedbyscrewtrafficiftherearealargenumberofscrewsfixingtheprimaryfracture.Inthisarticle,wereportanovelsurgicalapproachforthemanagementoftibialtuberclefracturefragmentsoccurringinassociationwithcomplexproxim
7、altibialfractures.Usingthistechnique,thetibialtuberclefragmentisstabilizedbywiringitdirectlytothescrewsofalockingplate.Itallowsforreductionandfixationofthetibialtuberclefragmentthatisstableenoughtoallowimmediatefullactiverangeofmotion.Overthepast5years,w
8、ehaveappliedthistechniquein16patients.Ourpreliminaryresultsusingthisnewtechniquehavedemonstratedahighrateofclinicalandradiographicunionwithnearnormalreturnofextensormechanismfunction.胫骨平台骨折合并胫骨结节骨折采用锁定钢板联合直接钢丝固定综述胫骨结节骨折导致伸
