医学ppt球囊成形治疗胫骨平台骨折课件.ppt

2015年6月 Balloon Tibioplasty: A Useful Tool for Reduction of Tibial Plateau Depression Fractures 球囊成形术治疗胫骨平台塌陷性骨折 导师：查振刚 教授 学生：顾容赫 * Schatzker type * The common fracture patterns encountered are split depression (OTA Type B3, Schatzker Type II) and lateral depression (OTA type B2,Schatzker type III).They prevailing in elderly patients due to osteopenia or osteoporosis。   Schatzker II Schatzker III 胫骨平台常见的Schatzker type II/III 骨折多见于骨质减少或骨质疏松的老年人。 Backgrounds Numerous techniques have been described to treat depressed tibial plateau fractures. With all techniques, the depression needs to be elevated mechanically with the use of metallic instruments through bone windows. 传统方法：切开在关节面塌陷下方开窗+金属棒撬拨+植骨填充+钢板内固定  Backgrounds Backgrounds shortage ： Depending on the instrument used and the bone quality, elevating a depressed fragment may make the defect worse or lead to intra-articular penetration. 不足 : 1）直接撬拨顶推创伤大。 2） 因骨质疏松，撬拨容易加重骨折。 3）植骨填充时，容易导致复位关节面 重 新塌陷或矫枉过正。  Method A fragment locking T-plate balloon  K-wires cortical screw 胫骨外侧锁定T形钢板 球囊 克氏针 皮质骨螺钉    Method Intraoperative fluoroscopic monitoring (side view) of the reduction process by balloon tibioplasty. Note the gradualelevation of the depressed articular area (arrows).  术中C臂透视侧位片，显示球囊成形过程。注意观察塌陷平台的抬高过程（箭头） A、 75year-old man with displaced split depression type fracture in CT of the tibial plateau (Schatzker type II). 75岁，男，胫骨平台骨折， Schatzker II  B、 Tibial plateau fractures Arthroscopic. 关节镜下胫骨平台Schatzker II 骨折表现   A B Patients Patients A、 A visual check under the lateral meniscus or an arthroscopic assessment of anatomic joint reduction completes the reduction proc