CAJ | 학술논문

目的：探讨经关节截骨术治疗创伤后后外侧平台骨折畸形愈合的策略和临床效果。方法回顾2007年1月至2012年1月收治的创伤后后外侧平台骨折畸形愈合患者共28例，其中男15例，女13例；年龄28~59岁，平均42.6岁；左侧16例，右侧12例。按 Schatzker 分型，Ⅱ型19例，Ⅲ型 9例。保守治疗导致胫骨平台外翻塌陷畸形8例，创伤术后畸形愈合20例。所有患者入院后均行经关节截骨术。结果随访骨折均愈合良好，平均愈合时间为12~18周（平均14.7周）。术后即刻与术后2年胫骨平台内翻角及股胫角比较，差异无统计学意义（P >0.05），所有患者术后膝关节稳定性及功能有明显改善。术后1例患者浅表感染经外科换药治愈，无骨不连，无内固定失效、松动、断裂。结论经关节截骨治疗创伤后后外侧平台骨折畸形愈合获得良好的治疗效果。
목적：탐토경관절절골술치료창상후후외측평태골절기형유합적책략화림상효과。방법회고2007년1월지2012년1월수치적창상후후외측평태골절기형유합환자공28례，기중남15례，녀13례；년령28~59세，평균42.6세；좌측16례，우측12례。안 Schatzker 분형，Ⅱ형19례，Ⅲ형 9례。보수치료도치경골평태외번탑함기형8례，창상술후기형유합20례。소유환자입원후균행경관절절골술。결과수방골절균유합량호，평균유합시간위12~18주（평균14.7주）。술후즉각여술후2년경골평태내번각급고경각비교，차이무통계학의의（P >0.05），소유환자술후슬관절은정성급공능유명현개선。술후1례환자천표감염경외과환약치유，무골불련，무내고정실효、송동、단렬。결론경관절절골치료창상후후외측평태골절기형유합획득량호적치료효과。
Objective The aim of this study is to report the results of reconstructive osteotomies performed to treat mal-unions of the posterlateral tibial plateau fractures. Methods From 2005 to 2010,28 cases that have underwent valgus mal-union of the tibial plateau fractures. According to schatzker classification,there were 19 cases of type Ⅱ and 9 cares of typeⅢ. All patients underwent intra-articular osteotomy of the malunited tibial plateau fractures. 8 patients had been treated conser-vatively and 20 surgically. Results The mean bone union time was 12 ~ 18 weeks(average 14. 7 weeks). There was no sig-nificant difference of TPA and FTA between postoperation and postoperation two years later. All patients were satisfied with their improvement in stability and knee function. Postoperatively,one patient had a superficial wound infection,which resolved with dressing. There were no nonunions and implant breakage or loosening. Conclusion Intra articular osteotomy can provide satisfactory results with posttraumatic malunions of the posterlateral tibia plateau fractures.