Uchida Hisaya, Minezaki Takatoshi, Mochida Joji
Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, Japan.
Tokai J Exp Clin Med. 2006 Sep 20;31(3):102-4.
Proximal tibial fractures are often difficult to treat and secondary osteoarthritis due to residual malalignment or irregularity of the articular surface is a common problem, especially in patients with comminuted fractures. The purpose of this retrospective study was to assess the relationship between the functional outcome and certain anatomical parameters as predictors for the prognosis in patients with AO type C fractures.
Clinical and functional data were collected on 24 AO type C fractures of the proximal tibia in 23 patients. The following factors were evaluated: the anatomical outcome, the tibial angle, the femoro-tibial angle, the medial and lateral tibial plateau angles, residual irregularity of the tibial plateau articular surface, and the functional outcome. The length of the follow-up period was 12 to 72 months.
A large tibial angle and a small medial tibial plateau angle were associated with a worse functional outcome. All of the knees with residual irregularity of the medial tibial plateau articular surface had a worse functional outcome, while lateral irregularity was associated with various outcomes.
These findings suggested that the medial compartment of the knee joint is more important than the lateral compartment for the short-term functional outcome.
胫骨近端骨折通常难以治疗,由于关节面残留对线不良或不平整导致的继发性骨关节炎是一个常见问题,尤其是在粉碎性骨折患者中。这项回顾性研究的目的是评估功能结果与某些解剖学参数之间的关系,这些参数可作为AO C型骨折患者预后的预测指标。
收集了23例患者24例AO C型胫骨近端骨折的临床和功能数据。评估了以下因素:解剖学结果、胫骨角、股骨-胫骨角、胫骨内外侧平台角、胫骨平台关节面残留不平整情况以及功能结果。随访时间为12至72个月。
胫骨角较大和胫骨内侧平台角较小与功能结果较差相关。所有胫骨内侧平台关节面残留不平整的膝关节功能结果均较差,而外侧不平整则与不同的结果相关。
这些发现表明,对于短期功能结果而言,膝关节内侧间室比外侧间室更重要。