中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
22期
3560-3564
,共5页
植入物%骨植入物%胫骨平台骨折%联合入路%Schatzker Ⅴ及Ⅵ型%Rasmussen评分%优良率%膝关节%稳定性%复位%愈合%功能%疗效
植入物%骨植入物%脛骨平檯骨摺%聯閤入路%Schatzker Ⅴ及Ⅵ型%Rasmussen評分%優良率%膝關節%穩定性%複位%愈閤%功能%療效
식입물%골식입물%경골평태골절%연합입로%Schatzker Ⅴ급Ⅵ형%Rasmussen평분%우량솔%슬관절%은정성%복위%유합%공능%료효
背景：Schatzker Ⅴ及Ⅵ型胫骨平台骨折后常伴严重的关节面塌陷、胫骨髁分离、软组织及周围血管损伤。为减少软组织损伤，临床上一般采用有限切开复位、螺钉克氏针内固定外加跨关节外固定架固定的生物学固定方法进行修复，但对关节面复位不够充分。目的：探讨膝关节内侧或后内侧与前外侧联合入路，置入内固定材料钛合金锁定加压钢板治疗 Schatzker Ⅴ及Ⅵ型胫骨平台骨折后的生物相容性效果。方法：回顾性分析SchatzkerⅤ及Ⅵ型胫骨平台骨折50例，采用膝前后联合入路锁定加钢板固定修复，观察患者的修复效果。结果与结论：经钢板置入固定后，50例患者骨折均临床愈合，无骨不连、内固定松动断裂等并发症发生。骨折解剖位置平均Rasmussen评分为(14.3±1.9)分，优良率90%；膝关节功能平均分为(24.3±2.5)分，优良率84%。固定后1年膝关节屈曲100°-130°，平均115°。结果证实，膝前后联合入路钢板置入修复 SchatzkerⅤ及Ⅵ型胫骨平台骨折，具有修复后骨稳定性好，骨折复位及功能恢复好等钢板与宿主生物相容性好的特点。
揹景：Schatzker Ⅴ及Ⅵ型脛骨平檯骨摺後常伴嚴重的關節麵塌陷、脛骨髁分離、軟組織及週圍血管損傷。為減少軟組織損傷，臨床上一般採用有限切開複位、螺釘剋氏針內固定外加跨關節外固定架固定的生物學固定方法進行脩複，但對關節麵複位不夠充分。目的：探討膝關節內側或後內側與前外側聯閤入路，置入內固定材料鈦閤金鎖定加壓鋼闆治療 Schatzker Ⅴ及Ⅵ型脛骨平檯骨摺後的生物相容性效果。方法：迴顧性分析SchatzkerⅤ及Ⅵ型脛骨平檯骨摺50例，採用膝前後聯閤入路鎖定加鋼闆固定脩複，觀察患者的脩複效果。結果與結論：經鋼闆置入固定後，50例患者骨摺均臨床愈閤，無骨不連、內固定鬆動斷裂等併髮癥髮生。骨摺解剖位置平均Rasmussen評分為(14.3±1.9)分，優良率90%；膝關節功能平均分為(24.3±2.5)分，優良率84%。固定後1年膝關節屈麯100°-130°，平均115°。結果證實，膝前後聯閤入路鋼闆置入脩複 SchatzkerⅤ及Ⅵ型脛骨平檯骨摺，具有脩複後骨穩定性好，骨摺複位及功能恢複好等鋼闆與宿主生物相容性好的特點。
배경：Schatzker Ⅴ급Ⅵ형경골평태골절후상반엄중적관절면탑함、경골과분리、연조직급주위혈관손상。위감소연조직손상，림상상일반채용유한절개복위、라정극씨침내고정외가과관절외고정가고정적생물학고정방법진행수복，단대관절면복위불구충분。목적：탐토슬관절내측혹후내측여전외측연합입로，치입내고정재료태합금쇄정가압강판치료 Schatzker Ⅴ급Ⅵ형경골평태골절후적생물상용성효과。방법：회고성분석SchatzkerⅤ급Ⅵ형경골평태골절50례，채용슬전후연합입로쇄정가강판고정수복，관찰환자적수복효과。결과여결론：경강판치입고정후，50례환자골절균림상유합，무골불련、내고정송동단렬등병발증발생。골절해부위치평균Rasmussen평분위(14.3±1.9)분，우량솔90%；슬관절공능평균분위(24.3±2.5)분，우량솔84%。고정후1년슬관절굴곡100°-130°，평균115°。결과증실，슬전후연합입로강판치입수복 SchatzkerⅤ급Ⅵ형경골평태골절，구유수복후골은정성호，골절복위급공능회복호등강판여숙주생물상용성호적특점。
BACKGROUND:Schatzker V and VI tibial plateau fractures are often accompanied by severe articular facet colapse, separation of tibial condyles, damage of soft tissue and peripheral blood vessels. To reduce soft tissue damage, clinical treatments include limited open and reduction, Kirschner wire internal fixation and external fixation, however, these treatments are ineffective for the reduction of articular facet. OBJECTIVE: To evaluate the biocompatibility of titanium aloy locking compression plate fixation through the medial or posteromedial combined anterolateral approaches for treatment of Schatzker V and VI tibial plateau fractures. METHODS:Fifty patients of Schatzker V and VI tibial plateau fractures recruited from our hospital were analyzed retrospectively, and were treated with locking plate fixation through the combined approaches. The repair effect in patients was observed. RESULTS AND CONCLUSION:After plate fixation, the fractures in 50 patients were clinicaly healed, no cases appeared nonunion, loosening or breakage. According to the Rasmussen Rating, anatomical location average score was (14.3±1.9) points, with the good rate of 90%; average score of knee function was (24.3±2.5) points, with the good rate of 84%. At 1 year post-surgery, knee flexion range was 100°-130°, average 115°. Experimental findings indicate that, the plate fixation through the combined approaches can achieve good stability, good fracture reduction, and good functional recovery in treatment of Schatzker V and VI tibial plateau fractures.
