El-Alfy Barakat, Othman Abdulsalam, Mansour Emad
Al-Razi Orthopaedic Hospital, Kuwait.
Acta Orthop Belg. 2011 Jun;77(3):349-54.
The aim of the present study is to assess the results of indirect reduction and hybrid external fixation in management of comminuted tibial plateau fractures. The study included 28 patients with high-energy tibial plateau fractures (Schatzker type V and VI). The ages ranged from 22 to 58 years with an average of 35 years. The trauma was a road traffic accident in 16 cases and a fall from a height in 12 cases. Concomitant soft tissue injuries were present in 18 cases such as skin wounds in 6 cases, excessive swelling with skin blisters in 9 cases, and compartment syndrome in 3 cases. After clinical and radiological evaluation all the patients were treated by indirect reduction using a traction table and a hybrid external fixator. The average time to healing was 3.2 months. At the final follow-up the range of knee movement ranged from 0 degrees-140 degrees with an average of 110 degrees. The results were satisfactory in 23 cases and unsatisfactory in 5 cases according to the Rasmussen knee functional score. Complications included pin tract infection in 12 cases, an extension lag in 2 cases, varus deformity of about 15 degrees in one case, deep infection in one case and early osteoarthritic changes in 2 cases. Hybrid external fixation is a good method for treatment of comminuted tibial plateau fractures. It allows for early joint movement and reduces the risk of serious complications.
本研究的目的是评估间接复位和混合外固定治疗胫骨平台粉碎性骨折的效果。该研究纳入了28例高能胫骨平台骨折患者（Schatzker V型和VI型）。年龄范围为22至58岁，平均35岁。创伤原因包括16例道路交通事故和12例高处坠落。18例伴有软组织损伤，其中6例有皮肤伤口，9例有过度肿胀伴皮肤水泡，3例发生骨筋膜室综合征。经过临床和影像学评估后，所有患者均采用牵引床和混合外固定器进行间接复位治疗。平均愈合时间为3.2个月。在末次随访时，膝关节活动范围为0度至140度，平均110度。根据Rasmussen膝关节功能评分，23例结果满意，5例不满意。并发症包括12例针道感染、2例伸直滞后、1例约15度的内翻畸形、1例深部感染和2例早期骨关节炎改变。混合外固定是治疗胫骨平台粉碎性骨折的一种好方法。它允许早期关节活动并降低严重并发症的风险。
