探讨应用塌陷骨块顶复器治疗SchatzkerⅡ、Ⅲ型胫骨平台骨折的临床效果。

2019年8月至今，汕头大学附属粤北人民医院创伤骨科应用塌陷骨块顶复器治疗SchatzkerⅡ、Ⅲ型胫骨平台骨折患者8例；其中Ⅱ型骨折4例，Ⅲ型骨折4例。所有患者均应用塌陷骨块顶复器复位胫骨平台关节面的塌陷骨折，经皮微创植入接骨板固定骨折端。采集手术时间、术中失血量等数据。术后定期随访，复查影像学检查；进行膝关节HSS评分和Rasmussen影像学评分评估患膝关节功能恢复情况；记录患膝关节屈曲角度和丢拐下床负重时间。

8例患者均获随访，随访时间10.00～14.00个月，平均( 11.50±1.32 ) 个月。所有患者骨折10个月内均骨性愈合。丢拐下床负重时间5～8周，平均( 5.88±1.05) 周。末次随访时，膝关节屈曲度为95.00°～125.00 °，平均(111.00±10.69) °；Rasmussen影像学评分优良率达100%；膝关节HSS评分78.00～90.00分，平均(84.25±4.89) 分。

应用塌陷骨块顶复器能将胫骨平台的塌陷骨折块解剖复位，恢复胫骨平台关节面平整；经皮微创植入钢板内固定，可最大程度地减少软组织和膝关节的损伤。术后疗效好，是治疗SchatzkerⅡ、Ⅲ型胫骨平台骨折的有效方法。

To evaluate the clinical effectiveness of special fracture block reduction device in mininally invasive treatment for Schatzker typeⅡand Ⅲ tibial plateau fractures.

From August 2019 to now, eight patients admitted to the Department of Orthopedic Surgery of Yuebei People′s Hospital Affiliated to Shantou University who suffered from Schatzker typeⅡand Ⅲ tibial plateau fractures were included into the study, there were four cases of typeⅡand four cases of type Ⅲ.All patients were treated with special fracture block reduction device .The treatment was evaluated according to the surgical time and blood loss, and functional outcomes were evaluated according to HHS scores and Rasmussen radiological scoring system. Time to get out of bed and load was scored.

All 8 patients were followed up for 10.00-14.00 months, with an average of (11.50±1.32 ) months. Time to get out of bed and load was 5 to 8 weeks, with an average of(5.88±1.05) weeks. All the fratures healed within 10 months postoperatively.At the last follow-up, the flexion of knee joint was 95.00° to 125.00 °, with an average of (111.00±10.69)°. The satisfaction rate was 100% according to Rasmussen radiological scoring system, and the mean HHS score was 78.00 to 90.00 points, with an average of (84.25±4.89) points.

Special fracture block reduction device is tested to be a feasible and worthwhile alternative for Schatzker typeⅡand Ⅲ tibial plateau fractures.