摘要
目的 探讨治疗胫骨平台伴胫骨上段骨折的最佳方法。 方法 1995年 12月～1999年 6月 ,采用笔者自行研制的半圆形动态交锁髓内钉 (SDLIN)治疗胫骨平台伴胫骨上段骨折2 1例。按M櫣ｌｌｅｒ(AO/ASIF)分类 ,C1、C2 、C3 型骨折分别为 6 ,10 ,5例 ,其中GustiloⅢA、ⅢB 型开放性骨折分别为 4,2例。SDLIN两侧钉分别自胫骨外髁偏前 1cm和胫骨内髁偏后 1cm进钉 ,其中央段相互咬合 ,钉尾上横栓加压 ,构成一整体结构。 结果 19例达解剖复位 ,2例功能复位。经平均40个月随访 ,骨折全部愈合 ,平均愈合时间 4.7个月。无断钉、断横栓、腓总神经损伤病例。患膝关节功能优良率为 95 %。 结论 (1)通过SDLIN钉尾横栓加压 ,可有效地固定胫骨平台骨折 ;(2 )通过两侧钉的相互咬合作用 ,可有效地固定胫骨上段骨折 ;(3)可早期进行患膝关节功能锻炼 ;(4 )便于局部软组织损伤的处理。
Objective To explore optimal treatment for the tibial p lat eau fractures accompanying proximal fractures. Methods Twenty-one patients wit h tibial plateau fractures accompanying proximal tibial fractures, in whom C_1, C_2,C_3 type fractures (AO classification) were in 6,10,5 cases, and Ⅲ_A?Ⅲ_B type open fractures in 4, 2 cases, respectively, were treated with semicircular dynamic locked intramedullary nail(SDLIN). The lateral part of the nail was inse rted into the medullary canal through the anterior site 1 cm to the midline of t he external condyle, and the medical part inserted through the posterior site 1 cm to the middle line of the internal condyle. Their tails were connected togeth er by a bolt. Results Follow-up of 12 to 54 months showed that there were no nonunion, no fracture displacement, no peroneus communis nerve injures, no na il or bolt breaking among the 21 cases. Anatomical reduction was found in 19 cas es and functional reduction 2 cases. The excellent and good functional recovery was 95%. Conclusions The advantages of SDLIN are that the plateaus fr acture and the proximal tibial fracture can be effectively fixed simultaneously; functional training can be carried out early so as to avoid suffering knees sti ffness and facilitate the local wound management.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第3期148-150,共3页
Chinese Journal of Trauma
关键词
股骨骨折
骨折固定术
髓内
半圆形态交锁髓内钉
Tibial plateau fractures
Fracture fixation, intramedul lary
Semicircular dynamic locked intramedullary nail
