Schatzker II型胫骨平台骨折治疗的关键在于塌陷关节面的复位,由于外侧髁的遮挡,前外侧入路通过关节间隙显露有限,既往有学者采用前外侧皮质开窗、钉棒复位技术复位塌陷的关节面,但由于对塌陷骨块的定位困难,临床应用存在劣势。有学者采用外侧髁截骨,将平台外侧髁骨块整体掀开以直视下暴露塌陷骨关节面,复位后螺钉固定,取得良好效果。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/c652f586-5822-4720-bc47-489473f6567d.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/d6ec5874-f8b3-48cc-aa1e-dad41180457c.jpg)
手术步骤
1.体位:仰卧位,经典前外侧入路。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/0876beb3-6ee4-48fe-9103-8ab0a4af1942.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/eca5d4a4-9908-4f3e-8439-1b99ae60b080.jpg)
2.外侧髁截骨。距平台4cm处外侧髁截骨,将外侧髁骨块整体翻转,暴露压缩的关节面。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/c32de3bf-d083-49e7-8ae3-275267de7d2c.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/0c25e97f-0969-434c-8062-60e53d8fd0b0.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/b7e8c65e-bdc0-47b9-9ec6-31b47fc54557.jpg)
3.复位固定。将塌陷的关节面复位,并予以2枚螺钉贴关节软骨下固定,缺损处植入人工骨。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/e7cf93be-d325-463a-b322-e7b525e7584b.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/e9ceb608-27d2-40d5-8d8d-227624a7a2ce.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/88e63cbe-05be-403a-b06e-7c18a5ff42ce.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/61199664-26b1-4b37-b75b-d2bf259ec6c2.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/d70c96bc-af76-4bf0-9da0-0b9f02826d35.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/87742cfe-fb1e-451a-b8bd-d8bfd4e62445.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/c86c56e7-b840-4f08-84b4-93f6738530d5.jpg)
5.病例1。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/3c474120-d57c-4012-979a-b80126e665f1.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/9c9dfea0-ce42-4bdd-886a-286b27dfa3c1.jpg)
6.病例2。
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/e2325499-199b-4f2a-89ec-75c5b1655932.jpg)
![【手术技巧】外侧髁截骨复位Schatzker](https://img-a.haoyishu.com/article/content/8944/1a0cb257-27d6-43f6-bdcd-aab1fe76fae1.jpg)
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