【摘要】 目的:探讨应用髂骨内板修复复杂胫骨平台骨折关节面缺损的可行性。方法:复杂胫骨平台骨折23例,男17例,女6例;年龄18～51岁,平均28.3岁。关节面缺损1cm×2cm～3cm×3cm,平均6.7cm2。取带骨膜髂骨内板,修剪成和缺损区匹配的形状,并用直径1.5mm的克氏针间隔3～4mm钻孔,凹面朝上置入缺损区,其下植骨,T形或L形钢板固定。术后石膏外固定4周。结果:23例经随访8个月～3年,平均13.6个月,X线片示骨折全部愈合,关节面平整。采用Rasmussen评价标准,优11例,良8例,可3例,差1例。结论:对于复杂胫骨平台骨折关节面缺损,应用髂骨内板进行修复可恢复关节面平整,使膝关节获得满意功能,方法简单易行,很少发生供区并发症,临床实用性较强,可修复较大面积关节面缺损。更多还原

【Abstract】 Objective:To study the feasibility of application of ilium inner table to repair the articular surface defects of tibial plateau complex fractures. Methods:Twenty-three patients with tibial plateau complex fractures included 17 males and 6 females with an average age of 28.3 years old ranging from 18 to 51 years. The area of the articular surface defects ranged from 1 cm×2 cm to 3 cm×3 cm,averaged 6.7 cm2. Taking ilium inner table with periosteum after trimmed and implanting into the articular surface defect area with the concavity upward and drilled with diameter1.5 mm Kirschner pin interval 3 to 4 mm. Bone grafting were placed under the ilium inner table and were fixed by T-shaped or L-shaped plate. The wounded limb were braked by plaster for 4 weeks after operation. Results:Twenty-three patients were followed-up for 8 months to 3 years,averaged 13.6 months. X-ray film showed solid union and the smooth articular surface in all cases. According to the Rasmussen evaluation system,the results were excellent in 11 cases,good in 8 cases,fair in 3 cases,poor in 1 case. Conclusion:Taking ilium inner table to repair the articular surface defects of tibial plateau complex fractures is a good resolving measures. It can repaire major area of articular surface defects,restore the smooth articular surface and acquire good function of knee joint with easy to operate,less complications at donor area.更多还原