摘要
目的:探讨治疗胫骨平台陈旧性骨折合并膝关节僵硬的临床经验。方法:2002年8月～2008年4月,对30例胫骨平台陈旧性骨折合并膝关节僵硬患者行膝关节松解并胫骨平台重建术,术后在踝上骨牵引下将患肢置于CPM机上行膝关节伸屈功能锻炼。结果:30例均获得门诊随访,平均随访时间7.2(4～13)个月,膝关节活动范围达120°以上者22例,90°～120°者6例,60°～89°者2例,60°以下者0例,平均113°。根据Hohl膝关节功能评价方法,按疼痛、主动活动能力及活动范围、稳定性及患者自我评价等五个项目进行综合评分,结果优21例,良7例,可2例,差0例,优良率93.3%。结论:胫骨平台陈旧性骨折合并膝关节僵硬的治疗,只有严格掌握适应证,选择合适的术式,并进行良好的功能锻炼,才能取得满意的治疗效果。全膝关节置换术只适用于老年患者,对于年轻的患者应尽可能行膝关节松解并胫骨平台重建术。
Objective：To study the treatment of old fractures of tibial plateau with stiffness of knee joint. Methods： From August 2002 to April 2008, relaxation of knee joint and reconstruction of old fracture of tibial plateau were performed in 30 patients with the old fracture of tibial plateau and stiffness of knee joint. After operation, knee joints received passively functional exercise of extension and flexion on the CPM. Results： All cases were followed up for 4 to 13 months, 7. 2 months averagely. Range of motion of knee joint was over 120° in 22 patients, 90°-120° in 6 patients, 60°-89° in 2 patients, and under 60°in 0 patient, 113° averagely. General scoring assessment showed that an excellent result was achieved in 21 patients, good in 7 patients, fair in 2 patients, and poor in 0 patient, with an excellent and good rate of 93.3% according to the Hohl knee joint function assessment on the pain, active movement, motion range, stability, and self--assessment. Conclusion： Only based on strict indications, proper choice of surgery type as well as fine functional exercise, the treatment for old fractures of tibial plateau with stiffness of knee joint can achieve favorable therapeutic effect.
出处
《中国中医骨伤科杂志》
CAS
2009年第9期45-47,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
胫骨平台骨折
关节僵硬
治疗
临床研究
Tibial plateau fracture
Arthral stiffness
Treatment
Clinical study
