CAJ | 학술논문

目的对胫骨平台骨折手术复位效果不佳的原因进行分析.方法对1995～2008年在本院治疗的胫骨平台骨折进行回顾,对其中35例关节面复位效果不佳的骨折,通过术后的X线片进行分析.结果总结出七种胫骨平台骨折手术复位效果不佳的原因:①与胫骨棘相连的关节面同时出现旋转、塌陷,复位后关节面出现中心凹陷;②骨折块本身有压缩,但手术时未将压缩部分撬起;③植骨不实,且螺钉拧得过紧,造成关节面再次移位;④未清除胫骨平台骨折间夹有碎骨块;⑤骨折整体复位垫起不足;⑥手术中摄X线片投照角度不佳,造成复位良好的假象;⑦骨折端过多的填塞植骨造成骨折分离移位.结论在胫骨平台骨折手术复位中,如能注意避免以上七种造成复位效果不佳的原因,将可能提高手术的复位水平.
목적 대경골평태골절수술복위효과불가적원인진행분석.방법 대1995～2008년재본원치료적경골평태골절진행회고,대기중35례관절면복위효과불가적골절,통과술후적X선편진행분석.결과 총결출칠충경골평태골절수술복위효과불가적원인:①여경골극상련적관절면동시출현선전、탑함,복위후관절면출현중심요함;②골절괴본신유압축,단수술시미장압축부분효기;③식골불실,차라정녕득과긴,조성관절면재차이위;④미청제경골평태골절간협유쇄골괴;⑤골절정체복위점기불족;⑥수술중섭X선편투조각도불가,조성복위량호적가상;⑦골절단과다적전새식골조성골절분리이위.결론 재경골평태골절수술복위중,여능주의피면이상칠충조성복위효과불가적원인,장가능제고수술적복위수평.
Objective To analyze the reasons for unsatisfactory open reduction of tibial plateau fracture.Methods Thirty-five tibial plateau fractures treated operatively from 1995 to 2008 with unsatis-factory articular reduction of the articular surface had been reviewed.Results Seven potential reasons for unsatis factory articular reduction were found:1)Failure to restore the rotational collapse of the articular surfaceconnected with the tibial eminence that results in central collapse of the reduced articular surface.2)The compression of the fracture fragment had not been completely lifted up during reduction,causing the incongruence of the articular surface.3)Redisplacement of the reduced articular surface may occur due to loose bong graft and/or the over-compression of the fixing screw.4)The minor fragments between the condylar fracture ling had not been cleared off.5)The inadequate lifting of the fractured condyle.6)Mimic image caused by inappropriate projection angle intraoperatively.7)Separation of the fractured condyles due to over-impaction of the bone graft between the fracture line.Conclusion Given the 7potential reasons being considered,a more successful reduction of the tibial plateau fracture may be achieved.