中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
10期
909-912
,共4页
楚宇鹏%孔建中%施俊武%李武
楚宇鵬%孔建中%施俊武%李武
초우붕%공건중%시준무%리무
胫骨骨折%体层摄影术,X线计算机%骨折固定术,内
脛骨骨摺%體層攝影術,X線計算機%骨摺固定術,內
경골골절%체층섭영술,X선계산궤%골절고정술,내
Tibial fractures%Tomographic,X-ray computed%Fracture fixation,internal
目的 探讨胫骨平台后侧双髁骨折的影像学特点、骨折块形态特征及其治疗方法.方法 选取2005年3月-2009年2月胫骨平台后侧双髁骨折47例,运用Starpacs系统在CT片上精确测量骨折特点和骨折块的形态.回顾性研究47例患者经胫骨平台前外侧入路联合前内侧入路、外侧髁钢板加内侧髁拉力螺钉内固定的治疗效果. 结果 后内侧髁为劈裂骨折,移位较小,骨折不稳定,骨折块呈倒三棱体,较完整；后外侧髁骨折为压缩性骨折.常伴有膝关节软组织损伤.术后Rasmussen影像学评分:优24例,良18例,可3例,差2例；Rasmussen功能评分:优13例,良27例,可2例,差5例. 结论 后内侧髁骨折块形态与Hohl“E”型骨折描述相似,后外侧髁骨折为压缩性骨折.经前外侧联合前内侧入路可以Ⅰ期植骨内固定骨折,同时修复合并损伤,达到良好的影像学结果及临床疗效.
目的 探討脛骨平檯後側雙髁骨摺的影像學特點、骨摺塊形態特徵及其治療方法.方法 選取2005年3月-2009年2月脛骨平檯後側雙髁骨摺47例,運用Starpacs繫統在CT片上精確測量骨摺特點和骨摺塊的形態.迴顧性研究47例患者經脛骨平檯前外側入路聯閤前內側入路、外側髁鋼闆加內側髁拉力螺釘內固定的治療效果. 結果 後內側髁為劈裂骨摺,移位較小,骨摺不穩定,骨摺塊呈倒三稜體,較完整；後外側髁骨摺為壓縮性骨摺.常伴有膝關節軟組織損傷.術後Rasmussen影像學評分:優24例,良18例,可3例,差2例；Rasmussen功能評分:優13例,良27例,可2例,差5例. 結論 後內側髁骨摺塊形態與Hohl“E”型骨摺描述相似,後外側髁骨摺為壓縮性骨摺.經前外側聯閤前內側入路可以Ⅰ期植骨內固定骨摺,同時脩複閤併損傷,達到良好的影像學結果及臨床療效.
목적 탐토경골평태후측쌍과골절적영상학특점、골절괴형태특정급기치료방법.방법 선취2005년3월-2009년2월경골평태후측쌍과골절47례,운용Starpacs계통재CT편상정학측량골절특점화골절괴적형태.회고성연구47례환자경경골평태전외측입로연합전내측입로、외측과강판가내측과랍력라정내고정적치료효과. 결과 후내측과위벽렬골절,이위교소,골절불은정,골절괴정도삼릉체,교완정；후외측과골절위압축성골절.상반유슬관절연조직손상.술후Rasmussen영상학평분:우24례,량18례,가3례,차2례；Rasmussen공능평분:우13례,량27례,가2례,차5례. 결론 후내측과골절괴형태여Hohl“E”형골절묘술상사,후외측과골절위압축성골절.경전외측연합전내측입로가이Ⅰ기식골내고정골절,동시수복합병손상,체도량호적영상학결과급림상료효.
Objective To investigate the radiological characteristics,morphological characteristics of fracture fragments and treatments of posterior bicondylar tibial plateau fractures.Methods A total of 47 patients with posterior bicondylar tibial plateau fractures treated between March 2005 and February 2009 were enrolled in the study.Characteristics of fractures and morphologies of fracture fragments were measured precisely with CT-chip Starpacs system.A retrospective study was carried out on the therapeutic results of the 47 patients undergone lateral condylar plate and medial condylar lag screw fixation via anterolateral combined with anteromedial tibial plateau approaches.Results Posteromedial condylar fracture was split one with small displacement,but the fracture was unstable.In the meantime,the fracture fragments were inverted three prism in shape and remained quite intact.Posterolateral condylar fracture was compression one and was often associated with soft tissue injury of knee joints.According to the Rasmussen radiology score,the results were excellent in 24 patients,good in 18,fair in three and poor in two.According to the Rasmussen function score,the results were excellent in 13 patients,good in 27,fair in two and poor in five.Conclusions The morphous of posteromedial condylar fracture is similar with that of Hohl type "E" fracture.The posterolateral condylar fracture is compression one.Anterolateral combined with anteromedial approaches for posterior tibial plateau fractures allow stage Ⅰ bone fusion with internal fixation,simultaneously repair recombined injuries and achieve excellent radiological and clinical results.
