Solomon L B, Callary S A, Stevenson A W, McGee M A, Chehade M J, Howie D W
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, North Terrace, Adelaide 5000, Australia.
J Bone Joint Surg Br. 2011 Jun;93(6):817-23. doi: 10.1302/0301-620X.93B6.26122.
We investigated the stability of seven Schatzker type II fractures of the lateral tibial plateau treated by subchondral screws and a buttress plate followed by immediate partial weight-bearing. In order to assess the stability of the fracture, weight-bearing inducible displacements of the fracture fragments and their migration over a one-year period were measured by differentially loaded radiostereometric analysis and standard radiostereometric analysis, respectively. The mean inducible craniocaudal fracture fragment displacements measured -0.30 mm (-0.73 to 0.02) at two weeks and 0.00 mm (-0.12 to 0.15) at 52 weeks. All inducible displacements were elastic in nature under all loads at each examination during follow-up. At one year, the mean craniocaudal migration of the fracture fragments was -0.34 mm (-1.64 to 1.51). Using radiostereometric methods, this case series has shown that in the Schatzker type II fractures investigated, internal fixation with subchondral screws and a buttress plate provided adequate stability to allow immediate post-operative partial weight-bearing, without harmful consequences.
我们研究了7例采用软骨下螺钉和支撑钢板治疗的胫骨外侧平台Schatzker II型骨折的稳定性，并在术后立即进行部分负重。为了评估骨折的稳定性，分别通过差异加载放射立体测量分析和标准放射立体测量分析，测量了骨折碎片在负重诱导下的位移及其在一年时间内的移位情况。在两周时，测量得到的骨折碎片头尾向平均诱导位移为-0.30 mm（-0.73至0.02），在52周时为0.00 mm（-0.12至0.15）。在随访期间的每次检查中，所有诱导位移在所有负荷下本质上都是弹性的。在一年时，骨折碎片的平均头尾向移位为-0.34 mm（-1.64至1.51）。通过放射立体测量方法，该病例系列表明，在所研究的Schatzker II型骨折中，采用软骨下螺钉和支撑钢板进行内固定提供了足够的稳定性，以允许术后立即进行部分负重，且无不良后果。
