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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 381 -383. doi: 10.3877/cma.j.issn.1674-134X.2022.03.021

个案报道

胫骨近端应力性骨折术后钢板断裂合并重度膝骨关节炎
韩向东1,(), 陈新良1, 王维军1, 张成1   
  1. 1. 255000 淄博市第七人民医院(淄博市骨科医院)
  • 收稿日期:2020-07-03 出版日期:2022-06-01
  • 通信作者: 韩向东

Postoperative locking plate broken following proximal tibia stress fracture with severe knee osteoarthritis

Xiangdong Han1(), Xinliang Chen1, Weijun Wang1   

  • Received:2020-07-03 Published:2022-06-01
  • Corresponding author: Xiangdong Han
引用本文:

韩向东, 陈新良, 王维军, 张成. 胫骨近端应力性骨折术后钢板断裂合并重度膝骨关节炎[J]. 中华关节外科杂志(电子版), 2022, 16(03): 381-383.

Xiangdong Han, Xinliang Chen, Weijun Wang. Postoperative locking plate broken following proximal tibia stress fracture with severe knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(03): 381-383.

胫骨近端应力性骨折合并膝骨关节炎常常给关节外科医师带来挑战。其处理方法可分为两种:第一种方法是一期固定胫骨骨折和全膝关节置换术(total knee arthroplasty,TKA)。第二种是两阶段固定法:首先使用任何适当的方法固定胫骨,在胫骨骨折愈合后,行全膝关节置换术。但两阶段固定法有一些缺点,如:下肢力线在未纠正的情况下进行胫骨骨折固定,未解决胫骨应力异常问题,增加了骨不连及内固定物断裂的风险;增加了两次手术中麻醉、内植物感染及伤口不愈合的风险,增加了患者的痛苦及恢复时间。选择一期处理或分期处理需要医师做出恰当的方案,笔者建议在同等条件下选择一期手术处理,并在此报道一个经历了以上两种治疗观点的病例,对以后此种病例的治疗有一定借鉴价值。

图5 患者术后康复运动,示下肢力线外形可,膝关节运动功能良好
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