目的探讨双侧钢板内固定治疗复杂胫骨平台骨折的临床效果。方法采用双侧钢板内固定加植骨治疗老年C型胫骨平台骨折患者29例，术中用双钢板固定，内侧采用滑动加压钢板（DC P ）或1/3管形钢板固定，外侧选择T形或L形解剖钢板或微创内固定系统潜行分离插入。术中充分植骨对关节面的复位起有效的支托作用。结果本组29例均获得随访，平均随访（13．8±2．43）个月，1年后膝关节Rasmussen评分优良率为82．7％。术后即刻与术后1年胫骨平台内分角（TPA）及后倾角（PA）比较，差异无统计学意义（P＞0．05）。结论双侧钢板治疗复杂老年胫骨平台骨折是简单有效的方法。术中充分植骨，术后引流通畅和早期功能锻炼，将明显提高疗效，减少并发症。%Objective To analyze the results of treatment of complicated tibial plateau fractures with open reduction and internal fixation with bilateral plates .Methods 29 elder patients with C type tibial platform fractures underwent internal fixation with bilat-eral plates and bone grafting .Fixation with bilateral plates was performed during operation with dynamic compression plate or 1/3 Tubular steel plate placed medially and the dissection plate or LISS system ones inserted laterally after the underlying separation . Meanwhile ,sufficient bone grafting during operation could effectively support reduction of articular surface .Results All patients were followed up of an average of 13 .8 ± 2 .43 months .According to Rasmussen score standard ,the excellent and good rate was 82 .7% .There was significant difference of TPA and PA between postoperation and postoperation one year later .Conclusion It is a simple and effective method to treat complicated elder tibial platform fractures with bilateral plates .It will improve the effect and re-duce complications significantly to perform sufficient bone grafting intraoperatively ,and make the drainage unobstructed and do the early functional exercises postoperatively .
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