Abstract: 【Abstract】 Objective To investigate the prognostic influence factors for tibial plateau fracture through clinical treatment and observation. Methods Sixty-two cases with tibial plateau fracture of were were collected in our hospital from January 2006 to December 2011. Among them, cases were treated by operation and the others(19 cases)were treated by non-operation. Results All the patients were followed up from 2 months to 5 years and the average follow-up period was 2.8 years. The excellent and good rates of tibial plateau fracture were 88.4% in operation group and 73.7% in non-operation group according to Lyslom's criteria. The prognosis of Schatzker Ⅰ, Ⅱand Ⅲ were significantly better than that of Ⅳ, Ⅴ and Ⅵ respectively (P<0.05). There was no significant difference in the excellent and good rates between males and females (P>0.05). The excellent and good rates of patients who were treated within 8 hours were significantly higher than that over 8 hours after the fracture (P<0.05), and the patients above 60 year-old were worse than those under 60 years old. Three cases of patients were found traumatic arthritis, and 2 patients had articular surface collaps in different degree. Conclusion Surgical treatment is an effective method for tivial plateau fracture. The type of tibial plateau fractures, the means of treatment and the selection of operative timing,early functional exercises and the age of patients have a significant impact on patient's prognosis.

Key words: Tibial Plateau, Fracture, Continuous passive movement

摘要： 【摘要】 目的 探讨影响胫骨平台骨折预后的因素,为临床治疗及康复提供依据。方法 收集2006年1月~2011年12月收治的62例胫骨平台骨折病例,其中非手术治疗19例,方法为抽取关节腔积血,加压包扎,石膏托外固定;手术治疗43例,方法为切开复位内固定。结果 临床治疗后均获得随访,随访平均时间2.8年。参照Lysolm评分标准,非手术治疗组优良率73.7%,手术治疗组优良率88.4%。SchatzkerⅠ、Ⅱ、Ⅲ型骨折优良率高于Ⅳ、Ⅴ、Ⅵ型(P<0.05);男性患者优良率稍高于女性患者,但差异无统计学意义;8小时内治疗的患者预后优良率高于8小时后治疗的患者(P<0.05);60岁以上患者预后优良率不及60岁以下患者。3例患者术后出现创伤性关节炎,2例患者术后出现不同程度的关节面塌陷。结论 手术是胫骨平台骨折的有效治疗方法。胫骨平台骨折类型,治疗方法和治疗时机的选择,患者年龄,早期功能锻炼可以影响胫骨平台骨折的预后。

关键词: 胫骨平台, 骨折, 连续被动活动