Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds, United Kingdom.
Int Orthop. 2011 Aug;35(8):1215-21. doi: 10.1007/s00264-010-1153-y. Epub 2010 Nov 25.
Between 2004 and 2009, 60 patients with proximal tibial fractures were included in this prospective study. All fractures were treated with the polyaxial locked-plate fixation system (DePuy, Warsaw, IN, USA). Clinical and radiographic data, including fracture pattern, changes in alignment, local and systemic complications, hardware failure and fracture union were analysed. The mean follow-up was 14 (12-36) months. According to the Orthopaedic Trauma Association (OTA) classification, there were five 41-A, 28 41-B and 27 41-C fractures. Fractures were treated percutaneously in 30% of cases. Double-plating was used in 11 cases. All but three fractures progressed to union at a mean of 3.2 (2.5-5) months. There was no evidence of varus collapse as a result of polyaxial screw failure. No plate fractured, and no screw cut out was noted. There was one case of lateral joint collapse (>10°) in a patient with open bicondylar plateau fracture. The mean Knee Society Score at the time of final follow-up was 91 points, and the mean functional score was 89 points. The polyaxial locking-plate system provided stable fixation of extra-articular and intra-articular proximal tibial fractures and good functional outcomes with a low complication rate.
在 2004 年至 2009 年期间，共有 60 例胫骨近端骨折患者纳入本前瞻性研究。所有骨折均采用多轴锁定钢板固定系统（DePuy，Warsaw，IN，USA）治疗。分析了临床和影像学数据，包括骨折类型、对线变化、局部和全身并发症、内固定失败和骨折愈合情况。平均随访时间为 14 个月（12-36 个月）。根据骨科创伤协会（OTA）分类，5 例为 41-A 型，28 例为 41-B 型，27 例为 41-C 型骨折。30%的病例采用经皮治疗，11 例采用双钢板治疗。所有骨折平均 3.2 个月（2.5-5 个月）愈合，除 3 例外无明显内翻塌陷。没有因多轴螺钉失败导致的矢状面塌陷证据。没有钢板断裂，也没有螺钉穿出。在一例开放性双髁平台骨折患者中，出现 1 例外侧关节塌陷（>10°）。末次随访时膝关节协会评分平均为 91 分，功能评分平均为 89 分。多轴锁定钢板系统为关节外和关节内胫骨近端骨折提供了稳定的固定，并发症发生率低，功能结果良好。
