Three Column Parting In The Clinical Application Of Complex Tibial Plateau Fractures

Aim:to investigate the effect of clinical treatment which is using threecolumn theory to cure complex tibial plateau fracture。Method:There are24patients of complex tibial plateau fracture which all beenfollowed up from August of2009to August of2012mentioned in ourresearch.14of the patients are male, the others are female. The meanage of the patients is36.8. They are being divided into two groupsaccording to the three column theory:20cases of double column fractureand4cases of three column fracture. Then choose the best operativeapproach and inner fixed approach. The opportunity of operationdepends on the degree of damage in the injured limb, the average time is8days after injury. All the patients that had bone compression defect indifferent degree received allogeneic grafts. Then the patients adoptedrehealthy training after operation. At last we collected and estimated thewhole effect of the patients the by following up.Result:The following up is9to24months, mean time13month. All thefractures were cured, the mean cure time is10.5weeks(8-28weeks).There were no skin necrosis, deep infection, osteomyelitis and internalfixation breakage cases. Because of the high age, one of cases is delayed union(7month). Three of them showed superficial infection, then healedafter anti-inflammatory symptomatic treatment and local flushing dressing.The average HSS score in12month after operation is85.7(61~96). Onepatient who is complex three column fracture could bend his knee’s to125degree on the8day after operation. The mean ankle of bend knees is120degree in all the patients.Conclusion:We received satisfactory curative effect in cure fracture of tibialplateau by three column theory. The advantages of this method are lessdestroy of soft tissue blood transport, great stability of the internal fixation,bone healing fast, function of joint quickly recovery and less postoperativecomplications. It is worth to research and spread.