本文選題：脛骨后外側(cè)平臺骨折　切入點：塌陷性骨折　出處：《中國修復(fù)重建外科雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)后外側(cè)入路有限切開、撬撥復(fù)位、簡單內(nèi)固定治療脛骨后外側(cè)平臺塌陷性骨折的臨床效果。方法 2010年10月—2016年1月,采用后外側(cè)入路、撬撥復(fù)位、克氏針或螺釘?shù)群唵蝺?nèi)固定治療16例脛骨后外側(cè)平臺塌陷性骨折患者。男10例,女6例;年齡22~63歲,平均43.5歲。致傷原因:跌傷5例,交通事故傷7例,高處墜落傷4例。均為閉合性骨折。左膝9例,右膝7例。傷后至入院時間為2 h~3 d,平均10 h。X線片示關(guān)節(jié)面塌陷2 mm;根據(jù)Schatzker分型標(biāo)準:Ⅱ型6例,Ⅲ型10例;其中12例合并腓骨頭骨折。觀察手術(shù)切口長度、手術(shù)時間、術(shù)中出血量、術(shù)后切口愈合情況;X線片觀察骨折愈合情況,測量脛骨平臺內(nèi)翻角和后傾角;CT復(fù)查關(guān)節(jié)面復(fù)位及再次塌陷情況。膝關(guān)節(jié)功能根據(jù)美國特種外科醫(yī)院(HSS)評分標(biāo)準進行評價。結(jié)果手術(shù)切口長度為7~10 cm,平均8.6 cm;手術(shù)時間35~55 min,平均46 min;術(shù)中出血量10~35 m L,平均28 m L。術(shù)后切口均Ⅰ期愈合。1例術(shù)后2個月發(fā)生克氏針退針導(dǎo)致的針尾刺激皮膚疼痛。術(shù)后15例獲隨訪,隨訪時間8~21個月,平均13.5個月。X線片復(fù)查示骨折均愈合,愈合時間3~6個月,平均4.8個月;術(shù)后即刻及1年時脛骨平臺內(nèi)翻角、后傾角比較差異均無統(tǒng)計學(xué)意義(t= 1.500,P=0.156;t= 1.781,P=0.097)。CT復(fù)查示術(shù)后即刻關(guān)節(jié)面解剖復(fù)位率為93.8%(15/16);末次隨訪時測量關(guān)節(jié)再次塌陷高度為0.1~1.2 mm,平均0.36 mm。末次隨訪時膝關(guān)節(jié)功能按HSS評分標(biāo)準,獲優(yōu)12例、良2例、可1例,優(yōu)良率為93.3%。結(jié)論經(jīng)后外側(cè)入路有限切開、撬撥復(fù)位、簡單內(nèi)固定治療脛骨后外側(cè)平臺塌陷性骨折具有損傷小、暴露充分、手術(shù)操作簡便、膝關(guān)節(jié)功能恢復(fù)滿意等優(yōu)點,植骨支撐、簡單內(nèi)固定可防止術(shù)后關(guān)節(jié)面再塌陷。
[Abstract]:Objective to investigate the clinical effect of limited incision, pry reduction and simple internal fixation through the posterolateral approach for the treatment of collapsed fractures of the posterolateral tibial plateau. Methods from October 2010 to January 2016, the posterolateral approach was used to pry the reduction. Simple internal fixation, such as Kirschner's needle or screw, was used to treat 16 patients with collapsing fracture of the posterior lateral tibial plateau. There were 10 males and 6 females, aged 22 to 63 years, with an average age of 43.5 years. The causes of injury were: 5 cases of falls and 7 cases of traffic accidents. There were 4 cases of falling injury at height, 9 cases of left knee and 7 cases of right knee. The average time from injury to admission was 2 hours and 3 days, with an average of 10 h. X ray film showed the articular surface collapse 2 mm, according to Schatzker classification criteria: type 鈪，

本文編號：1614275