CAJ | 학술논문

目的：探讨自行设计的健侧卧位腓骨小头前路治疗胫骨平台后外侧塌陷骨折的效果。方法2011年6月～2013年12月，采用自行设计的腓骨小头前路治疗胫骨平台后外侧塌陷骨折11例，按 Schatzker 分型，Ⅱ型1例，Ⅲ型9例，Ⅴ型1例。采用桡骨远端斜“T”形锁定钛板治疗10例，“L”形支撑钛板治疗1例。结果手术时间45～120 min，平均58 min。无切口感染、神经损伤等并发症。术后 X 线片示所有患者均达到解剖复位。骨折愈合时间8～14周，平均12周。术后16周按 Rasmussen 膝关节功能恢复评分标准，优9例，良2例。11例随访4～28个月，平均19个月，无关节不稳、复位丢失、内固定松动等并发症。结论健侧卧位腓骨小头前路显露清晰，术中不会出现复位丢失，是治疗胫骨平台后外侧塌陷骨折的理想入路。
목적：탐토자행설계적건측와위비골소두전로치료경골평태후외측탑함골절적효과。방법2011년6월～2013년12월，채용자행설계적비골소두전로치료경골평태후외측탑함골절11례，안 Schatzker 분형，Ⅱ형1례，Ⅲ형9례，Ⅴ형1례。채용뇨골원단사“T”형쇄정태판치료10례，“L”형지탱태판치료1례。결과수술시간45～120 min，평균58 min。무절구감염、신경손상등병발증。술후 X 선편시소유환자균체도해부복위。골절유합시간8～14주，평균12주。술후16주안 Rasmussen 슬관절공능회복평분표준，우9례，량2례。11례수방4～28개월，평균19개월，무관절불은、복위주실、내고정송동등병발증。결론건측와위비골소두전로현로청석，술중불회출현복위주실，시치료경골평태후외측탑함골절적이상입로。
Objective To introduce a self-designed surgical treatment for posterolateral collapse of tibial plateau fractures by using the healthy lateral position and fibula capitulum anterior approach. Methods From June 201 1 to December 2013,1 1 cases of posterolateral collapse tibial plateau fractures were treated by using the fibula capitulum anterior approach surgery.According to the Schatzker classification,9 cases were Schatzker Ⅲ type,1 case was Schatzker Ⅲ type with lateral platform undisplaced fracture,and 1 case was Schatzker Ⅲ type with medial column splitting fractures.Ten cases were operated by using oblique T-type distal radius titanium plate,and 1 case was operated by using L-shaped support titanium plate. Results The operation time was 45 -120 minutes (mean,58 minutes).No wound infection,nerve damage and other complications occurred.Postoperative X-ray showed that all cases reached anatomical reduction.Time of the bone healing was 8 -14 weeks,with a mean of 12 weeks.The function of the knee was evaluated 16 weeks after operation according to the Rasmussen’s scores,showing the results of excellent in 9 cases and good in 2 cases.All the cases were followed up from 4 -28 months (mean,19 months).No joint instability,loss of reduction,internal fixation loosening and other complications occurred. Conclusion The healthy lateral position and fibula capitulum anterior approach obtains a clear surgical vision,without influence to fracture reduction,being an effective surgical method in the treatment of posterolateral collapse tibial plateau fractures.