影响胫骨平台骨折疗效的因素

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64 cases of tibia platform fracture were received and treated from February1994 to December 2000. The patients were guided for rehabilitation treatment as early function exercise and herb washing esc, the effects were satisfactory and it is reported as following. rn1 Objects and methods rn1.1 Objects 64 cases,39 male,25 female, aged 16~ 72 years, 35 cases were at the left and 29 were at the right. 52 cases were treated in one week and 12 were from one week to two weeks.The fractures were of three types: There were 37 cases of exstrophy type, Degree I: Split fracture or compress fracture of tibia external condyle with little or no transportation. The indented articular facet of the compress was no more than 0.5 cm. There were 15 cases of Degree I in the group. Degree II: 1/3 articular facet at the outside of the external condyle was of split fracture and there were external transportation, the indentation of the internal 2/3 articular facet caused by the external condyle of the femur was no more than 1.0 cm. There were 13 cases of degree II in the group. Degree III: Fracture on both condyles and there were 7 cases of Degree III in the group. There were 18 cases of entropion type and 9 cases of vertical type in the group. rn1.2 Methods ( 1) Non- operation treatment ① The lower limbs were fixed with plaster support for two weeks, after swelling at the knee joints disappeared, legs were fixed for another 2~ 4 weeks with plaster support or tube support, there were 30 cases in the group and the method was suitable for Degree I and II of the exstrophy type and entropion or vertical types with little transportation.② Bone traction for 2 weeks, and 2~ 4 weeks of lower limb plaster support or tube support, or continual bone traction combined with early function exercise, there were 9 cases in the group and the method was suitable for Degree III and IV of the exstrophy type, entropion and vertical types with major transportation.( 2) Operation treatment ① Open reduction and inner fixation: 25 cases.② Treating the knee joint combined wounds: 3 cases of meniscus extirpation, 3 cases of inner collateral ligament repairing, one case of external collateral ligament repairing, 2 cases of anterior cruciate ligament repairing and one case of posterior cruciate ligament repairing.( 3) Rehabilitation treatment:① Quadriceps femoris muscle isometric contraction exercises from the third day after operation and plaster fixation, 20~ 30 times for each group and 40~ 60 groups for each day. The intensity was added gradually. ② Herb washing was added, it may be performed in two weeks after stitches taking out or plaster fixing, the prescript was as the following:Chuan qiong 15g,Red peony root 15g,Chinese angelica 15g,Cassia twig 15g,Two tooth achyranthes root 15g,Safflower 20g,Halite 15g,Licorice root 15g,Frankincense 15g,Myrrh 15g,Staghorn clubmoss herb 25g and Tuberculate speranskia herb 25g. Twice a day and 30 minutes for each time, each dose may be used for two days. ③ Knee joint function exercise with the help of the CPM two weeks after plaster fixation or operation, slight passive movement at early period may enhance local blood circulation and reduce the possibility of joint adhesion, passive exercise with greater ranges may be performed for the knee joints after four weeks. rn
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