Kilian U
Waldkrankenhaus Bad Düben, Fachkrankenhaus für Orthopädie.
Unfallchirurg. 2003 Dec;106(12):1046-50. doi: 10.1007/s00113-003-0643-4.
Intra-articular fractures of the tibial head pose a huge challenge for the surgeon. An increase of these fractures, especially in the elderly, has been observed in recent years. The cause of injury in the elderly is in most cases a slight trauma. The mechanism of dislocation plays only a subordinated role. These are serious injuries of the bone, which are accompanied by soft tissue lesions. Furthermore, there are some factors, which could have a negative effect on the treatment, such as osteoporosis, diseases of the vascular system, osteoarthrosis, limited coordination, and insufficient autologous cancellous bone. Every surgeon is aware of secondary, clinically relevant deficits after operative treatment of the tibial head in the elderly. We treated two elderly patients with different additional findings by total knee replacement.
胫骨近端关节内骨折给外科医生带来了巨大挑战。近年来，这类骨折的发生率有所上升，尤其是在老年人中。老年人受伤的原因在大多数情况下是轻微创伤。脱位机制仅起次要作用。这些是严重的骨损伤，并伴有软组织损伤。此外，还有一些因素可能对治疗产生负面影响，如骨质疏松、血管系统疾病、骨关节炎、协调性受限以及自体松质骨不足。每位外科医生都清楚老年人胫骨近端手术治疗后会出现临床上相关的继发性缺陷。我们通过全膝关节置换术治疗了两名伴有不同附加病症的老年患者。
