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[经后外侧倒L形入路3.5mm T形支撑钢板固定单纯后外侧胫骨平台骨折的临床观察]

[Clinical observation of 3.5 mm T support plate fixation for simple posterolateral tibial plateau fracture by posterolateral inverted L-shaped approach].

作者信息

Yang Xiaohai, Xu Feng, Yin Zifei, Wang Qing

机构信息

Department of Orthopedics, Traditional Chinese Medicine Hospital of Kunshan, Kunshan Jiangsu, 215300,

Department of Orthopedics, Traditional Chinese Medicine Hospital of Kunshan, Kunshan Jiangsu, 215300, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Jul 15;31(7):815-819. doi: 10.7507/1002-1892.201611071.

Abstract

OBJECTIVE

To summarize the effectiveness of 3.5 mm T support plate fixation for simple postero-lateral tibial plateau fractures by posterolateral inverted L-shaped approach.

METHODS

Between March 2011 and January 2016, 13 patients with simple posterolateral tibial plateau fracture were treated with 3.5 mm T support plate fixation by posterolateral inverted L-shaped approach. Of 13 cases, 6 were male and 7 were female, aged 28 to 52 years (mean, 43 years). The left side was involved in 5 cases and the right side in 8 cases. The causes of injury were traffic accidents in 6 cases, falls in 3 cases, and falling from height in 4 cases. All of patients had fresh closed fracture by X-ray, CT three dimensional reconstruction, and MRI. According to Schatzker classification, 4 cases were rated as type II and 9 cases as type III. The time between injury and operation was 5-9 days (mean, 7 days).

RESULTS

One case had incision skin necrosis, which was cured after debridement and skin grafting; and primary healing was obtained in the other cases. The patients were followed up 10-16 months (mean, 13 months). The X-ray film showed that the fracture line was blurred at 3 months after operation, and disappeared at 12 months after operation. There was no complications of wound infection, major neurovascular injury, loosening or breakage of internal fixation, and dislocation of joint surface. The Hospital for Special Surgery (HSS) knee function score was 94 (range, 89-97) at last follow-up; all were excellent.

CONCLUSION

The 3.5 mm T support plate fixation by posterolateral inverted L-shaped approach is one of preferred surgical method for the treatment of simple posterolateral tibial plateau fractures.

摘要

目的

总结采用后外侧倒L形入路3.5mm T形支撑钢板固定单纯后外侧胫骨平台骨折的疗效。

方法

2011年3月至2016年1月,对13例单纯后外侧胫骨平台骨折患者采用后外侧倒L形入路3.5mm T形支撑钢板固定。13例中,男6例,女7例,年龄28~52岁(平均43岁)。左侧5例,右侧8例。受伤原因:交通事故6例,跌倒3例,高处坠落4例。所有患者经X线、CT三维重建及MRI检查均为新鲜闭合性骨折。根据Schatzker分型,Ⅱ型4例,Ⅲ型9例。受伤至手术时间为5~9天(平均7天)。

结果

1例出现切口皮肤坏死,经清创植皮后治愈;其余患者均一期愈合。患者随访10~16个月(平均13个月)。X线片显示术后3个月骨折线模糊,术后12个月骨折线消失。未出现伤口感染、 major神经血管损伤、内固定松动或断裂及关节面脱位等并发症。末次随访时,美国特种外科医院(HSS)膝关节功能评分为94分(范围89~97分);均为优。

结论

后外侧倒L形入路3.5mm T形支撑钢板固定是治疗单纯后外侧胫骨平台骨折的首选手术方法之一。

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