【摘要】 目的探讨外侧入路锁定钢板并植骨治疗胫骨平台三柱骨折的技巧与疗效。方法采用外侧入路锁定钢板并植骨治疗胫骨平台三柱骨折,其中SchartkerⅤ型28例、SchartkerⅥ型35例,术中透视观察胫骨平台三柱骨折关节面的恢复情况,术后观察其固定的牢固程度、愈合情况及膝关节功能恢复程度。结果所有病例的胫骨平台三柱骨折关节面均明显恢复,随访时间6～18个月,骨折均骨性愈合,膝关节屈伸功能锻炼良好。术后1年膝关节HSS评分为76-93分(平均为84分),Rasmussen评分优良率达87.3%。术前术后HSS评分与Rasmussen评分、关节面塌陷恢复差异有统计学意义(P<0.01),与健侧差异无统计学意义(P>0.05)。结论外侧入路锁定钢板并植骨治疗胫骨平台三柱骨折(SchartkerⅤ型或SchartkerⅥ型),创伤小、固定可靠、并发症少、疗效满意,是治疗胫骨平台三柱骨折的有效方法。更多还原

【Abstract】 Objective To investigate the clinical effects of the treatment of three column tibial plateau fractures using lateral approached locking plate plus bone grafting.Methods Lateral,approached locking plate plus bone grafting were used to treat 63 cases of three column tibial plateau fractures,in which,28 cases were Schartker type Ⅴ fracture while other 35 cases were Schartker Ⅵ fracture.The restoration of the joint surface was observed intra-operatively and the internal fixation and bone healing and the level of the knee function restored was evaluated post-operatively.Results Intra-operatively,the joint surface was satisfactorily restored in all of the cases.Bony union was obtained in all of the cases after 6-18 months follow-up,accompanied by acceptable knee function.Post-operative knee HSS score was 84 in average(76-93),and the excellent rate of th Rasmussen score was 87.3%,which was statistically different as compared with that of pre-operation,but not statistically as compared with the opposite site postoperatively.As well,the restoration of joint surface was statistically different as compared with that of pre-operation but not as com pared with the opposite knee.Conclusion Using lateral approached locking plate plus bone grafting to treat three col umn tibial plateau fractures(Schartker Ⅴ or Schartker Ⅵ) is a minimally invasive approach,with reliable fixation,less complication,and satisfied clinical outcome.It is an effective treatment for these types of fractures.更多还原