Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C
Hannover Medical School, Hannover, Germany.
Clin Orthop Relat Res. 2005 Oct;439:207-14. doi: 10.1097/00003086-200510000-00036.
We prospectively followed a case series of 68 patients with 69 AO/ASIF 41-C-type fractures treated with the Less Invasive Stabilization System for the proximal lateral tibia. We assessed malreduction, secondary loss of reduction, and infection rates in patients with a locked screw plate for unilateral fixation of bicondylar fractures. Sixty-two (91%) patients returned for final followup (range, 11-13 months). Malreduction and malalignment were defined as an intraarticular step-off of 2 mm or greater, or as a malalignment in the frontal or sagittal plane greater than 5 degrees . Fourteen fractures were open. Primary bone grafting was done in 13 patients. Significant malreduction was seen in 16 patients. There were four superficial infections and one deep infection. One fracture did not heal, and nine patients had substantial loss of reduction. Unilateral locked screw plating is a good alternative for treatment of problematic fractures of the tibial plateau that are associated with soft tissue damage and metaphyseal comminution. The reduction technique for exact alignment is demanding.
我们前瞻性地追踪了68例患有69处AO/ASIF 41-C型骨折的患者，这些骨折采用微创稳定系统治疗胫骨近端外侧。我们评估了使用锁定螺钉钢板单侧固定双髁骨折患者的复位不良、复位二次丢失和感染率。62例（91%）患者返回进行最终随访（范围为11 - 13个月）。复位不良和对线不良定义为关节内台阶超过2毫米，或额状面或矢状面对线不良超过5度。14处骨折为开放性骨折。13例患者进行了一期植骨。16例患者出现明显复位不良。有4例浅表感染和1例深部感染。1处骨折未愈合，9例患者出现明显的复位丢失。单侧锁定螺钉钢板是治疗伴有软组织损伤和干骺端粉碎的胫骨平台疑难骨折的良好替代方法。精确对线的复位技术要求较高。
