后外侧胫骨平台骨折ppt课件.pptx

后外侧胫骨平台骨折潘德悦定义胫骨平台骨折是指骨折线累及胫骨近端关节面的骨折后外侧胫骨平台的定义？后外侧 后外侧胫骨平台解剖解剖解剖后侧血管A：46.3±9.0mmB：35.7±9.0mm腘动脉胫前动脉ATA不能结扎！！！解剖后外侧复合体！！！ （PLC）维持膝关节后外侧稳定外侧副韧带腘肌腱复合体腘腓韧带弓状韧带后外侧关节囊解剖外翻角：87° （85-90°） 后倾角：0-10°Cong-Feng Luo.Reference axes for reconstruction of the knee. The Knee 2004, 11:253-257损伤机制低能量损伤外翻内翻过伸伸直屈曲影像学检查X线CTMRICTA或动脉血管造影分型Schatzker 分型AO/OTA分型三柱分型Hohl-Moore分型Schatzker 分型Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Torontoexperience 1968--1975. Clin Orthop Relat Res. 1979 Jan-Feb;(138):94-104.AO/OTA分型关节外骨折(Type A)单髁骨折(Type B)双髁骨折(TyPe C)三柱分型Luo CF, Sun H, Zhang B, Zeng BF. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma. 2010 Nov;24(11):683-92.这是几型？AO ： 41-B3Schatzker：Ⅱ型 三柱：外侧+后侧柱 治疗治疗手术治疗指征关节塌陷和分离3 mm干骺端明显移位或成角5开放性骨折合并血管神经损伤出现骨筋膜间隔综合征等屈膝不稳————单纯后外侧平台骨折1.Thomas C，Athanasiov A，Wullschleger M，et a1．Current concepts in tibial plateau fractures[J]．Acta Chir Orthop Traumatol Cech，2009，76(5)：363．373．2.Papagelopoulos PJ,Partsinevelos AA,Themistocleous GS,et al.Complications after tibia plateau fracture surgery[J].Injury,2006,37(6)：475—484．治疗前外侧入路后正中入路Hughston JC. A surgical approach to the medial and posterior ligaments of the knee. Clin Orthop Relat Res 1973;91(91):29–33倒L入路Luo CF, Sun H, Zhang B, Zeng BF. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma. 2010 Nov;24(11):683-92.治疗扩大 Tscherne-Johnson 入路Johnson EE, Timon S, Osuji C. Surgical technique: Tscherne-Johnson extensile approach for tibial plateau fractures. Clin Orthop Relat Res. 2013 Sep;471(9):2760-7.后外侧骨折后外侧切口入路Chang SM, Zheng HP, Li HF, Jia YW, Huang YG, Wang X, Yu GR. Treatment ofisolated posterior coronal fracture of the lateral tibial plateau throughposterolateral approach for direct exposure and buttress plate fixation. ArchOrthop Trauma Surg. 2009 Jul;129(7):955-62后外侧骨折后外侧切口入路Chang SM, Zheng HP, Li HF, Jia YW, Huang YG, Wang X, Yu GR. Treatment ofisolated posterior coronal fracture of the lateral tibial plateau throughposterolate