Lowe Jason A, Tejwani Nirmal, Yoo Brad J, Wolinsky Philip R
Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA.
Instr Course Lect. 2012;61:39-51.
In managing complex proximal tibia fractures, several options are available to the treating surgeon. Closed management with or without external fixation, formal open reduction and internal fixation, and intramedullary nail fixation have been described in the literature. There is a lack of consensus regarding the optimal treatment method for complex bicondylar patterns or proximal metadiaphyseal fractures with or without involvement of the articular surface. It is helpful to review the standard and alternative surgical approaches to bicondylar tibial plateau fractures and to be aware of the intramedullary nail as an alternative approach for complex proximal metadiaphyseal patterns.
在处理复杂的胫骨近端骨折时，治疗外科医生有多种选择。文献中描述了采用或不采用外固定的闭合治疗、正规切开复位内固定以及髓内钉固定。对于复杂双髁型骨折或累及或未累及关节面的近端干骺端骨折的最佳治疗方法，目前尚无共识。回顾双髁胫骨平台骨折的标准和替代手术方法，并了解髓内钉作为复杂近端干骺端骨折类型的替代方法是有帮助的。
