中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2014年
6期
495-498
,共4页
王立坤%孙正考%于腾波%张亦军%张增方%纪伟
王立坤%孫正攷%于騰波%張亦軍%張增方%紀偉
왕립곤%손정고%우등파%장역군%장증방%기위
胫骨%骨折%骨折固定术,内%三柱理论
脛骨%骨摺%骨摺固定術,內%三柱理論
경골%골절%골절고정술,내%삼주이론
Tibia%Fractures,bone%Fracture fixation,internal%Three-column theory
目的 探讨三柱理论在复杂胫骨平台骨折治疗中的临床应用和疗效分析.方法 自2009年1月至2012年1月收治41例复杂胫骨平台骨折,男26例,女15例;年龄23～56岁,平均35.7岁;按照三柱分型:双柱骨折22例,三柱骨折19例.所有患者均采用手术治疗,根据三柱理论采用合理的手术入路及内固定方式.结果 33例患者随访12 ～ 24个月(平均17.4个月),骨折愈合时间为10～ 15周(平均14.3周),完全负重时间为12～ 16周(平均14.9周).膝关节活动度7例伸直受限,受限范围小于10°,平均活动范围121.1°(95°～133°).3例患者术后前外侧伤口裂开,经换药后愈合,未发生深部感染;无一例患者发生内固定松动及断裂.术后内侧平台后倾角平均为8°(6°～10°),外侧平台后倾角平均为6°(5°～9°).根据Rasmussen评分系统评定膝关节功能:优20例,良9例,可4例,优良率为87.9％.结论 利用三柱理论对复杂胫骨平台骨折的手术入路和内固定方式可以起到有效的指导作用,从而提高疗效.
目的 探討三柱理論在複雜脛骨平檯骨摺治療中的臨床應用和療效分析.方法 自2009年1月至2012年1月收治41例複雜脛骨平檯骨摺,男26例,女15例;年齡23～56歲,平均35.7歲;按照三柱分型:雙柱骨摺22例,三柱骨摺19例.所有患者均採用手術治療,根據三柱理論採用閤理的手術入路及內固定方式.結果 33例患者隨訪12 ～ 24箇月(平均17.4箇月),骨摺愈閤時間為10～ 15週(平均14.3週),完全負重時間為12～ 16週(平均14.9週).膝關節活動度7例伸直受限,受限範圍小于10°,平均活動範圍121.1°(95°～133°).3例患者術後前外側傷口裂開,經換藥後愈閤,未髮生深部感染;無一例患者髮生內固定鬆動及斷裂.術後內側平檯後傾角平均為8°(6°～10°),外側平檯後傾角平均為6°(5°～9°).根據Rasmussen評分繫統評定膝關節功能:優20例,良9例,可4例,優良率為87.9％.結論 利用三柱理論對複雜脛骨平檯骨摺的手術入路和內固定方式可以起到有效的指導作用,從而提高療效.
목적 탐토삼주이론재복잡경골평태골절치료중적림상응용화료효분석.방법 자2009년1월지2012년1월수치41례복잡경골평태골절,남26례,녀15례;년령23～56세,평균35.7세;안조삼주분형:쌍주골절22례,삼주골절19례.소유환자균채용수술치료,근거삼주이론채용합리적수술입로급내고정방식.결과 33례환자수방12 ～ 24개월(평균17.4개월),골절유합시간위10～ 15주(평균14.3주),완전부중시간위12～ 16주(평균14.9주).슬관절활동도7례신직수한,수한범위소우10°,평균활동범위121.1°(95°～133°).3례환자술후전외측상구렬개,경환약후유합,미발생심부감염;무일례환자발생내고정송동급단렬.술후내측평태후경각평균위8°(6°～10°),외측평태후경각평균위6°(5°～9°).근거Rasmussen평분계통평정슬관절공능:우20례,량9례,가4례,우량솔위87.9％.결론 이용삼주이론대복잡경골평태골절적수술입로화내고정방식가이기도유효적지도작용,종이제고료효.
Objective To investigate the clinical application and curative effect of three-column theory in the treatment of complex fractures of tibial plateau.Methods From January 2009 to January 2012,41 cases of complex fractures of tibial plateau were treated in our department.Of them,22 were double column fractures and 19 three-column ones according to the three-column classification.All the cases were treated with proper operative approaches and internal fixation based on the three-column theory.Results Of all the patients,33 were followed up for 12 to 24 months (average,17.4 months).Their fractures healed after 10 to 15 weeks (average,14.3 weeks).Time for full weight-bearing averaged 14.9 weeks.A limitation of less than 10° to the knee extension was found in 7 cases.The range of motion of the knee averaged 121.1° (from 95° to 133°).Anterolateral wound dehiscence occurred in 3 cases but was cured by dressing without deep infection.No loosening or breakage occurred.The retroversion angle of the medial plateau averaged 8° (from 6° to 10°) and the retroversion angle of the lateral plateau averaged 6° (from 5° to 9°).By the Rasmussen evaluation,20 cases were excellent,9 good and 4 fair,giving a good to excellent rate of 87.9％.Conclusion The three-column theory can well guide the choice of operative approach and internal fixation for specific treatment of complex fracture of tibial plateau,thus enhancing the curative effect.
