Jeff A. Giulietti is Graduate Student in the Master of Physical Therapy Program at Slippery Rock University, Slippery Rock, PA 16057.
J Athl Train. 1994 Mar;29(1):32-5.
In general, tibial plateau fractures are rarely associated with noncontact, twisting, injuries to the knee in athletics. A 23-year-old woman sustained a noncontact valgus injury to her left knee while playing indoor soccer. Evaluation on-site and the following morning revealed no deformity and only mild pain over the anterolateral tibial plateau. All stress tests of the knee were negative. A 2+ effusion was noted the day after injury, causing us to suspect an internal derangement of the left knee. A nondisplaced tibial plateau fracture was confirmed by radiographs. The patient was treated non-operatively with a hinged knee brace and protective weight bearing with axillary crutches. Ten weeks following the injury, radiographs revealed a healed fracture, and the patient was instructed to gradually increase her athletic activity. The mechanism of injury and symptoms suggested injury to the tibial collateral ligament and anterior cruciate ligament. The physical examination findings, however, led us to believe otherwise. It is important to recognize that valgus stresses to the knee can result in damage to structures other than the soft tissues (ie, tibial collateral ligament). This injury resulted in a nondisplaced tibial plateau fracture that healed uneventfully with appropriate nonoperative treatment.
一般来说，胫骨平台骨折很少与运动中膝关节的非接触性、扭转性损伤有关。一名 23 岁的女性在室内足球比赛中左膝遭受非接触性外翻伤。现场评估和次日早上的检查均未发现畸形，仅在前外侧胫骨平台处有轻度疼痛。所有膝关节的应力试验均为阴性。受伤后第二天发现 2+关节积液，使我们怀疑左膝关节内部紊乱。X 线片证实存在无移位胫骨平台骨折。患者采用铰链式膝关节支具非手术治疗，并使用腋杖保护性负重。受伤后 10 周，X 线片显示骨折愈合，嘱患者逐渐增加体育活动。损伤机制和症状提示胫侧副韧带和前交叉韧带损伤。然而，体格检查结果提示并非如此。重要的是要认识到，膝关节外翻应力可导致除软组织（即胫侧副韧带）以外的结构损伤。这种损伤导致无移位胫骨平台骨折，经适当的非手术治疗后顺利愈合。
