Puno R M, Vaughan J J, Stetten M L, Johnson J R
Department of Orthopaedic Surgery, University of Louisville, Kentucky 40292.
J Orthop Trauma. 1991;5(3):247-54. doi: 10.1097/00005131-199109000-00001.
Twenty-seven patients with 28 tibial fractures were evaluated for an average of 8.2 years (range 6.0-12.3 years) following their injuries. There were 16 closed and 12 open fractures, all of which healed uneventfully. Overall, 50% of the ankles and 75% of the knees were rated good to excellent. The patients' knee and ankle joint malalignments were extrapolated using a method previously published. This was made possible by knowing both the degree and site of angular deformity. Correlation between joint malalignments and clinical outcome were performed. Analysis showed that greater degrees of ankle malalignment produce poorer clinical results (p = 0.001). Conversely, the patients with lesser degrees of ankle joint malalignment had a higher percentage of good to excellent results (p = 0.006, p = 0.003, p = 0.03). The knee results did not correlate with the degree of joint malalignment (p = 0.82). The findings in this study show that there is merit in reducing tibial fractures as close to anatomical configuration as possible to lessen the chance of early degenerative arthritis.
27例伴有28处胫骨骨折的患者在受伤后平均接受了8.2年（范围6.0 - 12.3年）的评估。其中有16例闭合性骨折和12例开放性骨折，所有骨折均顺利愈合。总体而言，50%的踝关节和75%的膝关节评级为良好至优秀。使用先前发表的一种方法推断患者的膝关节和踝关节排列不齐情况。这通过了解角畸形的程度和部位得以实现。对关节排列不齐与临床结果之间进行了相关性分析。分析表明，踝关节排列不齐程度越大，临床结果越差（p = 0.001）。相反，踝关节排列不齐程度较小的患者中，良好至优秀结果的比例更高（p = 0.006，p = 0.003，p = 0.03）。膝关节结果与关节排列不齐程度无关（p = 0.82）。本研究结果表明，尽可能将胫骨骨折复位至接近解剖结构对于减少早期退行性关节炎的发生几率具有重要意义。
