CAJ | 학술논문

目的探讨经腓骨截骨人路治疗胫骨平台后外侧骨折的疗效.方法自2009年8月至2011年8月,采用经腓骨截骨入路治疗17例胫骨平台后外侧骨折患者,男12例,女5例;年龄24～76岁,平均37.8岁.按Schatzker胫骨平台骨折分类法:Ⅱ型骨折8例,Ⅲ型骨折3例,Ⅴ型骨折6例.所有患者随访中摄X线片评估骨折愈合情况,记录随访过程中出现的并发症,并采用Rasmussen放射评分标准对患者膝关节的X线表现进行评估,根据末次随访结果采用Rasmussen评分标准评定膝关节功能.结果 17例患者均获得随访,随访时间为9～35个月,平均18个月.骨折愈合时间为10～18周,平均13.5周.随访期间未见高度丢失,术后1例出现腓总神经损伤症状,小腿远端外侧、足背出现局部感觉减退,术后2周恢复.Rasmussen放射评分14.0～18.0分,平均17.5分.膝关节活动度-5°-0°-135°,平均活动范围123.5°.膝关节功能按照Rasmussen评分为22～30分,平均26.9分.结论经腓骨截骨治疗胫骨平台后外侧骨折暴露充分,复位及固定满意,不会出现血管神经损伤及膝关节屈曲挛缩畸形,术后膝关节稳定性及功能恢复良好.
목적 탐토경비골절골인로치료경골평태후외측골절적료효.방법 자2009년8월지2011년8월,채용경비골절골입로치료17례경골평태후외측골절환자,남12례,녀5례;년령24～76세,평균37.8세.안Schatzker경골평태골절분류법:Ⅱ형골절8례,Ⅲ형골절3례,Ⅴ형골절6례.소유환자수방중섭X선편평고골절유합정황,기록수방과정중출현적병발증,병채용Rasmussen방사평분표준대환자슬관절적X선표현진행평고,근거말차수방결과채용Rasmussen평분표준평정슬관절공능.결과 17례환자균획득수방,수방시간위9～35개월,평균18개월.골절유합시간위10～18주,평균13.5주.수방기간미견고도주실,술후1례출현비총신경손상증상,소퇴원단외측、족배출현국부감각감퇴,술후2주회복.Rasmussen방사평분14.0～18.0분,평균17.5분.슬관절활동도-5°-0°-135°,평균활동범위123.5°.슬관절공능안조Rasmussen평분위22～30분,평균26.9분.결론 경비골절골치료경골평태후외측골절폭로충분,복위급고정만의,불회출현혈관신경손상급슬관절굴곡련축기형,술후슬관절은정성급공능회복량호.
Objective To explore the effect of treating posterolateral tibial plateau fractures via the fibular osteotomy approach.Methods From August 2009 to August 2011,17 patients with posterolateral tibial plateau fractures,including 12 males and 5 females,aged from 24 to 76 years (average,37.8 years),were treated via the fibular osteotomy approach in our hospital.According to the Schatzker classification,8 cases were type Ⅱ,3 cases were type Ⅲ,6 cases were type V.After operation,X-rays were taken in all patients,and Rasmussen's radiological and functional gradings were used to evaluate radiological and functional outcomes of knees.Results All patients obtained follow-up,ranged from 9 to 35 months (average,18months).The healing time of the fracture ranged from 10.0 to 18.0 weeks (average,13.5 weeks).During the period of followed-up,there was no loss of reduction; one case presented with symptoms of common peroneal nerve injury,such as local hypesthesia in distal lateral lower leg and dorsi pedis,which recovered two weeks postoperatively.According to Rasmussen's radiological grading,the mean score of the knee joint was 17.5(range,14.0 to 18.0).The range of motion of the knee joint ranged from -5°to 135°(average,123.5o).According to Rasmussen's functional grading,the mean score of the knee joint was 26.9 (range,22 to 30).Conclusion Treating posterolateral tibial plateau fractures via the fibular osteotomy approach can obtain sufficient exposure,good reduction and fixation,and avoid flexion contracture of the knee and peripheral vascular nerve injury.Moreover,postoperative function and stability of the knee joint recover well.