Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, No. 600, Yishan Road, Shanghai 200233, People's Republic of China.
Int Orthop. 2012 Nov;36(11):2355-60. doi: 10.1007/s00264-012-1646-y. Epub 2012 Aug 23.
The objective of this study was to evaluate the morphological characteristics of Schatzker type IV tibial plateau fractures.
A retrospective analysis of radiographic and computed tomographic data of tibial plateau Schatzker type IV fractures from January 2010 to December 2011 was conducted in a level 1 trauma centre. The medial fracture angle (MFA), surface area percentage (SAP), and medial fracture height (MFH) were measured on CT images using the Picture Archiving and Communication System.
Based on the location of fracture and the MFA, 75 cases of Schatzker type IV fracture were divided into three subtypes: anteromedial fracture (seven cases, 9.3 %), total medial plateau fracture (36 cases, 48 %), and posteromedial fracture (32 cases, 42.7 %). The anteromedial fracture was located on the anterior part of the medial plateau, the average MFA was positive 47.5°, the SAP was 38.3 % and the MFH was 41.6 mm. The total medial plateau fracture usually involved the entire medial plateau, the mean value of MFA was 81.2°, the SAP was 53.9 % and the MFH was 64.0 mm. The posteromedial fracture was located on the posterior part of the medial plateau, the MFA was negative 42.5°, the SAP was 32.4 % and the MFH was 44.8 mm.
The direction and location of Schatzker type IV fractures are highly variable. Proper operative approach and fixation method should be selected based on the morphological characteristics of individual medial plateau fractures.
本研究旨在评估 Schatzker Ⅳ型胫骨平台骨折的形态学特征。
在一家 1 级创伤中心，对 2010 年 1 月至 2011 年 12 月间的胫骨平台 Schatzker Ⅳ型骨折的影像学和计算机断层扫描（CT）数据进行回顾性分析。使用影像归档和通信系统（Picture Archiving and Communication System）在 CT 图像上测量内侧骨折角（medial fracture angle，MFA）、表面积百分比（surface area percentage，SAP）和内侧骨折高度（medial fracture height，MFH）。
根据骨折位置和 MFA，75 例 Schatzker Ⅳ型骨折分为 3 个亚型：前内侧骨折（7 例，9.3%）、全内侧平台骨折（36 例，48%）和后内侧骨折（32 例，42.7%）。前内侧骨折位于内侧平台前部，平均 MFA 为正 47.5°，SAP 为 38.3%，MFH 为 41.6mm。全内侧平台骨折通常累及整个内侧平台，MFA 的平均值为 81.2°，SAP 为 53.9%，MFH 为 64.0mm。后内侧骨折位于内侧平台后部，MFA 为负 42.5°，SAP 为 32.4%，MFH 为 44.8mm。
Schatzker Ⅳ型骨折的方向和位置变化多样。应根据个体内侧平台骨折的形态学特征选择合适的手术入路和固定方法。
