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中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 119 -123. doi: 10.3877/cma.j.issn.1674-134X.2020.01.022

所属专题: 文献

临床经验

胫骨锁定钢板治疗复杂胫骨平台骨折的疗效及并发症分析
杨健胜1, 吴焯鹏1,(), 匡光志1, 关万宁1   
  1. 1. 529300 开平市中心医院骨科
  • 收稿日期:2019-06-13 出版日期:2020-02-01
  • 通信作者: 吴焯鹏

Analysis of efficacy and complications of tibial locking plate in treatment of complex tibial plateau fractures

Jiansheng Yang1, Zhoupeng Wu1(), Guangzhi Kuang1, Wanning Guan1   

  1. 1. Department of Orthopaedic Surgery, Kaiping Central Hospital, Kaiping 529300, China
  • Received:2019-06-13 Published:2020-02-01
  • Corresponding author: Zhoupeng Wu
引用本文:

杨健胜, 吴焯鹏, 匡光志, 关万宁. 胫骨锁定钢板治疗复杂胫骨平台骨折的疗效及并发症分析[J]. 中华关节外科杂志(电子版), 2020, 14(01): 119-123.

Jiansheng Yang, Zhoupeng Wu, Guangzhi Kuang, Wanning Guan. Analysis of efficacy and complications of tibial locking plate in treatment of complex tibial plateau fractures[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(01): 119-123.

目的

探讨锁定钢板治疗复杂胫骨平台骨折患者的临床疗效,分析并发症发生的原因并提出预防处理方法。

方法

回顾性分析2016年1月至2019年1月采用胫骨锁定钢板内固定治疗56例复杂胫骨平台骨折患者的临床资料,根据Rasmussen膝关节功能评分评估手术疗效,观察术后并发症发生情况。

结果

平均随访时间(12±6)个月。末次随访时根据Rasmussen膝关节功能评分标准,优25例、良26例、中5例,优良率91%。术后出现1例伤口感染,2例膝关节轻度内翻,1例膝关节不稳定。

结论

胫骨锁定钢板治疗复杂胫骨平台骨折患者手术时间短、损伤小,患者术后膝关节功能恢复满意,但仍存在一定并发症,要术者做好充分的术前评估,熟练掌握手术技巧,尽可能减少术后并发症的发生。

Objective

To explore the clinical effects of tibial locking plate for treating patients with complex tibial plateau fractures, and to analyze the causes of complications and to provide the prevention and countermeasures.

Methods

Clinical data of 56 patients with complex tibial plateau fractures treated by tibial locking plate from January 2016 to January 2019 in Kaiping Central Hospital were retrospectively analyzed. Therapeutic effects were evaluated according to Rasmussen knee function score, and the postoperative complications were observed.

Results

The follow-up time was(12±6)months on average. According to Rasmussen knee function scoring criteria, there were excellent in 25 cases, good in 26, fair in five, with the excellent and good rate of 91.07% at the last follow-up. Postoperative complications included one case of wound infection, two cases of mild varus of knee joint, one case of knee instability.

Conclusion

For patients with complex tibial plateau fractures, tibial locking plate has the advantages of short operation time, minor injury and satisfactory recovery of knee function; but certain postoperative complications still exist, which need surgeons to evaluate the patients before the surgery adequately, have proficient surgical skills, so as to reduce the incidence of complications as far as possible .

图1 典型病例术前右膝正侧位X线片,示右胫骨平台骨折,Schatzker Ⅵ型
图2 典型病例术后1 d右膝正侧位X线片,示填充的人工骨颗粒,骨折已复位固定
图3 典型病例术后3月右膝正侧位X线片,示骨折愈合,膝关节间隙无狭窄,膝关节力线稍内翻
图4 典型病例术后18个月右膝关节正侧位X线片,示右膝关节间隙无狭窄,骨折愈合良好,钢板固定无移位
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