Ringus Vytautas M, Lemley Frederick R, Hubbard David F, Wearden Stanley, Jones Dina L
Orthopedic Foot and Ankle Center, Westerville, OH 43082, USA.
Orthopedics. 2010 Feb;33(2):80-4. doi: 10.3928/01477447-20100104-05.
The goal of this study was to determine if the degree of lateral tibial plateau fracture depression on computed tomography (CT) images predicted the presence of lateral meniscus tears. The study group comprised 85 patients who sustained a lateral tibial plateau fracture and underwent open reduction and internal fixation by the same surgeon. Degree of plateau depression was measured in millimeters by CT. Operative reports were retrospectively reviewed to determine if the lateral meniscus tear was intact or torn at the time of surgery. Twenty-eight patients had a lateral meniscus tear noted at the time of surgery. No significant differences existed in gender, mechanism or energy level of injury, Schatzker classification, or type of fracture among patients with a lateral meniscal tear as compared to those without a tear. Patients with > or =10 mm of plateau depression had an eight-fold increase in risk of having a lateral meniscus tear compared to those with <10 mm of depression. Patients younger than 48 years had a four-fold increase in risk of having a lateral meniscus tear than older patients.This study demonstrated an association between the amount of tibial plateau depression and the likelihood of a lateral meniscus tear. These findings may be used to predict those who have sustained a tear of the lateral meniscus and to advise the surgeon to prepare for a repair. Further prospective studies using magnetic resonance imaging as a tool to evaluate the extent of soft tissue injuries in plateau fractures is needed.
本研究的目的是确定计算机断层扫描（CT）图像上胫骨外侧平台骨折的凹陷程度是否能预测外侧半月板撕裂的存在。研究组包括85例发生胫骨外侧平台骨折并由同一位外科医生进行切开复位内固定的患者。通过CT以毫米为单位测量平台凹陷程度。回顾性查阅手术报告，以确定手术时外侧半月板是完整还是撕裂。28例患者在手术时发现有外侧半月板撕裂。与无撕裂的患者相比，有外侧半月板撕裂的患者在性别、损伤机制或能量水平、Schatzker分类或骨折类型方面无显著差异。与凹陷<10 mm的患者相比，平台凹陷≥10 mm的患者发生外侧半月板撕裂的风险增加了8倍。年龄小于48岁的患者发生外侧半月板撕裂的风险比年龄较大的患者增加了4倍。本研究表明胫骨平台凹陷程度与外侧半月板撕裂的可能性之间存在关联。这些发现可用于预测那些发生外侧半月板撕裂的患者，并建议外科医生做好修复准备。需要进一步进行前瞻性研究，使用磁共振成像作为评估平台骨折软组织损伤程度的工具。
