- 期刊
Treatment of Tibial Plateau Fracture
脛骨平台骨折之治療
摘要
脛骨平台骨折是種尚稱常見的骨折。但在法療上，因結果常不甚理想，仍有諸多爭議。過去數十年關於治療上採用保守療法抑或手術療法的文端見諸國外醫學雜誌的數以百計。但因分類的不同，以及各家先入為主的做法，無法做一客觀的比較。然而脛骨平台骨折是一個人體載重關節的關節內骨折，若治療結果不甚理想，往往需做重建手術，或遺留下不可挽救的關節僵硬及變形，造成病人行動不便的終生缺憾。近年來由於骨折內固定術 ( Ingernal fixation或稱Osteosynth esis )的進步，越來越多的論述報導手術療法之優點;尤其是關節內骨折，完美的骨折後位及堅牢的固定漸成為骨科醫師的共識。在諸多內固定手術法中又以瑞士內固定研究協會 ( Swiss AO group )所發展出來的方法最為各方注目。 榮總台中分院開創一年半共計有25位病人因新鮮的 ( fresh )脛骨平台骨折住院，平均年齡52.8歲，多為摩托車車禍引起。其中12例接受AO方法施行內固定術，8例得到滿意之結果; 4例接受AO以外之內固定術，包括K-wires及Bolts，只有1例得到滿意之結果。另有5例接受保守療法，有4例得到良好結果，主要是因為此類病人骨折較為單純。本文認為在只有些微移位的脛骨平台骨折，可使用保守療法。若須使用手術復位，AO手術療法不失為一良好之選擇。
關鍵字
無資料並列摘要
Twenty-five patients with fresh tibial plateau fractures tractures treated at VGH-Taichung from Nov. 1982 to Jun. 1984 were reviewed. Five patients with simpler fracture without significant depression or splitting of the articular surface were treated conservatively. Twenty patients with significant depression and splitting of tibial plateau received open treatment with anatomic reduction and rigid fixation by A-O buttress plates or other intermal fixations. Twenty-one patients had completed follow up for 6 months minimally. The results were assessed according to the criteria of Blokker, and 13 patients had satisfactory recovery. The present review suggests that anatomic reduction with supporting bone graft and rigid internal fixation not only result in good functional recovery but also a shortened period of disability.
延伸閱讀
- Wu, S. S., & Shaw, K. Y. (1987). 脛骨平臺骨折. Journal of Orthopaedic Surgery Taiwan, 4(4), 179-186. https://www.airitilibrary.com/Article/Detail?DocID=10116923-198712-4-4-179-186-a
- Cheng, Y. M., Chang, J. K., Hsu, C. Y., Huang, S. D., & Lin, S. Y. (1994). 下脛骨骨切術矯治踝關節炎. The Kaohsiung Journal of Medical Sciences, 10(8), 430-437. https://doi.org/10.6452/KJMS.199408.0430
- Lau, M. J., Chen, H. C., Chen, E. T. H., & Huang, V. W. S. (2003). 脛骨高丘骨折合併後內側斷片的治療：改良式固定法及個案報告. Journal of Orthopaedic Surgery Taiwan, 20(1), 36-41. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200303-20-1-36-41-a
- Chen, Y. W., Huang, P. J., Hsu, C. Y., Kuo, C. H., Cheng, Y. M., Lin, S. Y., Chen, L. H., & Chiang, H. C. (1998). 遠端脛骨併踝關節骨折之手術治療一觀血復位及內固定術. The Kaohsiung Journal of Medical Sciences, 14(1), 31-35. https://doi.org/10.6452/KJMS.199801.0031
- Wang, S. A. (2012). 微創鋼板固定手術治療複雜性脛骨骨折. 童綜合醫學雜誌, 6(1), 18-24. https://doi.org/10.29838/TMJ.201206.0003