创伤外科杂志
創傷外科雜誌
창상외과잡지
JOURNAL OF AUMATIC SURGERY
2014年
3期
244-247
,共4页
胫骨骨折%髁间嵴%钢板%内固定
脛骨骨摺%髁間嵴%鋼闆%內固定
경골골절%과간척%강판%내고정
tibial fracture%intercondylar eminence%plate%internal fixation
目的：探讨开放复位内固定治疗胫骨平台伴髁间嵴骨折的临床疗效。方法2007年6月～2011年6月对收治的42例胫骨平台伴髁间嵴骨折采用切开复位钢板内固定治疗，同时行钢丝固定髁间嵴骨折36例，6例未固定。胫骨平台骨折按Schatzker分型：Ⅲ型8例，Ⅳ型18例，Ⅴ型10例，Ⅵ型6例；胫骨髁间嵴骨折按Meyers McKeever分型：Ⅰ型6例，Ⅱ型17例，Ⅲ型13例，Ⅳ型6例。结果术后1例切口发生脂肪液化并感染，经清创、负压吸引及II期缝合后愈合，余伤口均Ⅰ期愈合。随访12～26个月，平均18个月。末次随访时，患者膝关节伸直均达到0°，屈膝80°～150°，平均122°；膝关节稳定性检查：3例Lachman试验及前抽屉试验（ ADT）为阳性；参照Rasmussen膝关节功能评分标准：优16例，良19例，可4例，差3例；优良率为83.3％。7例发生膝关节创伤性关节炎，3例胫骨髁间嵴骨折未愈合。结论手术治疗胫骨平台伴髁间嵴骨折应重视对髁间嵴骨折的固定，包括无移位的髁间嵴骨折，有利于术后早期功能锻炼及维持膝关节稳定。
目的：探討開放複位內固定治療脛骨平檯伴髁間嵴骨摺的臨床療效。方法2007年6月～2011年6月對收治的42例脛骨平檯伴髁間嵴骨摺採用切開複位鋼闆內固定治療，同時行鋼絲固定髁間嵴骨摺36例，6例未固定。脛骨平檯骨摺按Schatzker分型：Ⅲ型8例，Ⅳ型18例，Ⅴ型10例，Ⅵ型6例；脛骨髁間嵴骨摺按Meyers McKeever分型：Ⅰ型6例，Ⅱ型17例，Ⅲ型13例，Ⅳ型6例。結果術後1例切口髮生脂肪液化併感染，經清創、負壓吸引及II期縫閤後愈閤，餘傷口均Ⅰ期愈閤。隨訪12～26箇月，平均18箇月。末次隨訪時，患者膝關節伸直均達到0°，屈膝80°～150°，平均122°；膝關節穩定性檢查：3例Lachman試驗及前抽屜試驗（ ADT）為暘性；參照Rasmussen膝關節功能評分標準：優16例，良19例，可4例，差3例；優良率為83.3％。7例髮生膝關節創傷性關節炎，3例脛骨髁間嵴骨摺未愈閤。結論手術治療脛骨平檯伴髁間嵴骨摺應重視對髁間嵴骨摺的固定，包括無移位的髁間嵴骨摺，有利于術後早期功能鍛煉及維持膝關節穩定。
목적：탐토개방복위내고정치료경골평태반과간척골절적림상료효。방법2007년6월～2011년6월대수치적42례경골평태반과간척골절채용절개복위강판내고정치료，동시행강사고정과간척골절36례，6례미고정。경골평태골절안Schatzker분형：Ⅲ형8례，Ⅳ형18례，Ⅴ형10례，Ⅵ형6례；경골과간척골절안Meyers McKeever분형：Ⅰ형6례，Ⅱ형17례，Ⅲ형13례，Ⅳ형6례。결과술후1례절구발생지방액화병감염，경청창、부압흡인급II기봉합후유합，여상구균Ⅰ기유합。수방12～26개월，평균18개월。말차수방시，환자슬관절신직균체도0°，굴슬80°～150°，평균122°；슬관절은정성검사：3례Lachman시험급전추체시험（ ADT）위양성；삼조Rasmussen슬관절공능평분표준：우16례，량19례，가4례，차3례；우량솔위83.3％。7례발생슬관절창상성관절염，3례경골과간척골절미유합。결론수술치료경골평태반과간척골절응중시대과간척골절적고정，포괄무이위적과간척골절，유리우술후조기공능단련급유지슬관절은정。
Objective To investigate the clinical efficacy of open reduction and internal fixation in the treatment of tibial plateau and intercondylar eminence fracture .Methods Between Jun.2007 and Jun.2011,42 cases of tibial plateau and intercondylar eminence fracture were treated by open reduction and internal fixation . Meanwhile,steel wire fixation was used for fracture of tibial intercondylar eminence in 36 cases.According to the Schatzker classification of tibial plateau fracture ,there were 8 cases of type Ⅲ,18 cases of type Ⅳ,10 cases of typeⅤ,6 cases of type Ⅵ.According to the Meyers McKeever classification of tibial intercondylar eminence fracture , there were 6 cases of type Ⅰ,17 cases of type Ⅱ,13 cases of type Ⅲ,6 cases of type Ⅳ.Results Primary heal-ing was achieved in all cases except 1 case of postoperative incision with fat liquefaction and infection , who was cured by debridement ,vacuum aspiration and suture in the secondary stage .All cases were followed up for 12-26 months (mean 18 months).At the last follow-up,the extension of knee joint was 0°and the flexion of knee joint was 80 °-150 °(mean, 122 °).Lachman test and ADT test of knee joint stability indicated positive in 3 cases.Ac-cording to the Rasmussen scoring system ,there were 16 cases of excellent , 19 cases of good , 4 cases of fair and 3 cases of poor .The excellent and good rate was 83.3%.Traumatic osteoarthritis in knee joint occurred in 7 cases and nonunion of tibial intercondylar eminence fracture occurred in 3 cases.Conclusion During the operative treat-ment of tibial plateau and intercondylar eminence fracture ,attention should be paid to the fixation for intercondylar eminence fracture , including non-displaced fracture of tibial intercondylar eminence , which allows early exercise af-ter operation and maintains the stability of knee joint .
