| 王政团,张远金,杨汉明,等.三柱固定治疗胫骨平台粉碎性骨折的疗效分析.骨科,2016,7(2): 98-101. |
| 三柱固定治疗胫骨平台粉碎性骨折的疗效分析 |
| Effectiveness of three-column fixation in the treatment of comminuted fracture of tibial plateau |
| 投稿时间：2015-05-25 |
| DOI：10.3969/j.issn.1674-8573.2016.02.007 |
| 中文关键词: 胫骨 骨折 评价研究 |
| 英文关键词: Tibia Fractures Evaluation studies |
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| 中文摘要: |
| 目的 探讨三柱理论指导下三柱固定治疗胫骨平台粉碎性骨折的临床疗效。方法 回顾性分析2009年1月至2012年12月收治的胫骨平台粉碎性骨折40例患者，男25例，女15例；年龄为29~64岁，平均（36.6±3.1）岁。均为三柱骨折，所有患者采用漂浮体位下三柱固定，平台塌陷处以同种异体骨植入。术后X线片观察骨折复位及愈合程度，评价标准采用美国特种外科医院（hospital for special surgery, HSS）膝评分、Rasmussen胫骨平台骨折复位放射学评分，并观察并发症的发生情况。结果 术后随访2年，所有患者术后即刻均得到良好固定，膝关节内翻角和后倾角均得到很好纠正，Rasmussen放射学评分满意，术后与术前比较差异有统计学意义（P＜0.05）。膝关节功能恢复满意，术后2年HSS评分优良率为95%。2例患者出现轻度创伤性关节炎，其他患者无明显并发症。结论 采用三柱固定理论有利于胫骨平台粉碎性骨折的临床治疗，主要体现在中期随访中，三柱固定可使骨折获得更好的复位和牢固的固定，安全性较高，值得临床推广。 |
| 英文摘要: |
| Objective To investigate the the clinical effect of three-column fixation in the treatment of comminuted tibial plateau fracture under the guidance of three-column theory. Methods Forty cases of comminuted fracture of tibial plateau from January 2009 to December 2012 were collected, including 25 males, and 15 females with age ranging 29-64 years old (average, 36.6±3.1 years old). All patients were subjected to three-column fixation, and tibial plateau depression was treated with bone graft. After postoperative follow-up of 2 years, fracture reduction and healing were observed by X-ray examination, and HSS score and Rasmussen score were compared. At the same time the complications were observed. Results The fixation was good, postoperative knee varus angle and dip angle were well corrected, and Rasmussen score was satisfied. There was significant difference before and after operation (P＜0.05). Knee joint function was restored. According to HSS score, the effective rate of knee joint function was 95% at 2nd year postoperation. There were no obvious complications except 2 patients with traumatic arthritis. Conclusion Three-column fixation theory is conducive beneficial in clinical treatment of comminuted tibial plateau fracture, mainly in the medium-term follow-up. Three-column fixation can obtain better fracture reduction and stable fixation with high security. |
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