Schatzker V、VI型胫骨平台骨折的临床进展

Clinical Progress of Schatzker V and VI Tibial Plateau Fractures

摘要: 胫骨平台骨折，为临床上常见的下肢骨折之一。常因严重的暴力作用于膝关节而引起。胫骨平台骨折隶属关节内骨折范畴，故对骨折处理方式的选择很大程度上对膝关节的功能以及预后产生影响。由于受伤机制的复杂性，此类骨折常伴有关节周围组织、韧带损伤和半月板严重破坏，因此在后期正确处置这些损伤也是治疗此类骨折的不能缺少的环节，病人在后期仍常因膝关节力线问题和关节位置不稳定，对膝关节功能和活动产生巨大影响，严重时可影响患者的正常生活质量。由于近现代创伤骨科的进一步发展，对于复杂型胫骨平台骨折的治疗理念也不断更新，特别是对于Schatzker V型、VI型的复杂型胫骨平台骨折，切开复位钢板内固定、牵引复位、微创治疗以及生物学固定是目前临床上治疗此类骨折的大方向。对伴有严重软组织损伤的胫骨平台骨折治疗方案的选择一直是临床争论的焦点，选择正确合适有效的治疗对于此类骨折以及病人的预后至关重要。近年来，双反牵引技术的应用则为解决此类难题提供了一项新的选择。现对复杂型胫骨平台骨折的治疗现状进行阐述。

Abstract: Tibial plateau fracture is one of the common lower limb fractures in clinic, often caused by severe violence on the knee. Tibial plateau fracture belongs to the category of intra-articular fracture, so the choice of fracture treatment has an impact on the function and prognosis of knee joint to a great extent. Due to the complexity of the injury mechanism, such fractures are often accompanied by damage to the surrounding tissues and ligaments and serious damage to the meniscus. Therefore, the correct treatment of these injuries in the later stage is also an indispensable link for the treatment of such fractures. Patients often have a great impact on the function and activity of the knee joint due to the problem of the force line of the knee joint and the instability of the joint position in the later stage. In severe cases, it can affect the normal quality of life of patients. Due to the further development of modern trauma orthopedics, the treatment concept of complex tibial plateau fractures is also constantly updated, especially for Schatzker V and VI complex tibial plateau fractures. Open reduction, plate internal fixation, traction reduction, minimally invasive treatment and biological fixation are the general direction of clinical treatment of such fractures. The choice of treatment scheme for tibial plateau fracture with serious tissue injury has always been the focus of clinical debate. Choosing correct, appropriate and effective treatment is very important for this kind of fracture and the prognosis of patients. In recent years, the application of double anti-traction technology provides a new choice to solve such problems. This paper expounds the treatment status of complex tibial plateau fractures.