Department of Orthopaedics, Ningbo 6th Hospital, Ningbo 315040, China.
Arch Orthop Trauma Surg. 2013 Jan;133(1):23-8. doi: 10.1007/s00402-012-1632-2. Epub 2012 Oct 19.
To present a case series of patients with posterior bicondylar tibial plateau fractures treated by direct exposure and buttress plate fixation through posterior inverted L-shaped approach.
Between August 2007 and July 2010, eight middle aged patients were identified to have posterior bicondylar tibial plateau fractures. All the eight patients underwent direct fracture exposure, reduction under visualization, and buttress plate fixation through posterior inverted L-shaped approach.
All the cases were followed for an average of 28.1 months (24-36 months). All the cases had satisfactory reduction except one case, which had a 3-mm stepoff postoperatively. None of the complications such as infection, necrosis of the skin incision or the loosening and breakage of the internal fixator occurred. The average radiographic bony union time and full weightbearing time were 11.5 weeks (10-14 weeks), and 13.8 weeks (11-17 weeks) respectively. The average range of motion of the affected knee was from 3.6° to 127.8° at 1 year after the operation.
The posterior inverted L-shaped approach would not involve osteotomy, tendotomy or division of muscles, while allowing satisfied visualization of the entire posterior aspect of tibial plateau and appropriate placement of hardware. This approach is a safe and effective way for the treatment of posterior bicondylar tibial plateau fractures.
介绍通过后倒 L 形入路直接显露和支撑钢板固定治疗后髁双髁胫骨平台骨折的病例系列。
2007 年 8 月至 2010 年 7 月，共确定 8 例中年患者患有后髁双髁胫骨平台骨折。所有 8 例患者均通过后倒 L 形入路直接显露骨折，在直视下复位，并采用支撑钢板固定。
所有病例平均随访 28.1 个月（24-36 个月）。除 1 例术后有 3mm 台阶外，所有病例均获得满意复位。无感染、切口皮肤坏死、内固定器松动断裂等并发症发生。平均影像学骨愈合时间和完全负重时间分别为 11.5 周（10-14 周）和 13.8 周（11-17 周）。术后 1 年，患膝平均活动度为 3.6°至 127.8°。
后倒 L 形入路不涉及截骨、肌腱切断或肌肉分离，但能充分显露胫骨平台后侧面，并能适当放置内固定物。该入路是治疗后髁双髁胫骨平台骨折的一种安全有效的方法。
