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胫骨平台骨折手术治疗的结果。

Results following operative treatment of tibial plateau fractures.

作者信息

Urruela Adriana M, Davidovitch Roy, Karia Raj, Khurana Sonya, Egol Kenneth A

机构信息

Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York 10003, USA.

出版信息

J Knee Surg. 2013 Jun;26(3):161-5. doi: 10.1055/s-0032-1324807. Epub 2012 Sep 10.

Abstract

A total of 96 displaced tibial plateau fractures in 94 patients (average age, 48 years) were treated with open reduction and internal fixation. At 12 months postoperatively, mean range of knee motion was 126 degrees and 10 (10%) of the patients had required a secondary surgery. Using a binary regression model, no demographic variable such as age, gender, smoking history, diabetes, BMI; or fracture characteristic such as mechanism of injury, initial plateau depression, Schatzker classification was identified that correlated with short-term functional outcome such as a complication, range of motion, healing time, or residual depression. We determined that radiographic fracture reduction was not superior following fractures with less initial displacement, and increased plateau collapse at 12 months postoperatively was not indicative of decreased function. However, an increased postoperative articular step-off was found to be associated with an increased risk of plateau collapse (p < 0.01). Furthermore, at 12 months, 76% of the patients had returned to their preinjury employment and the overall complication rate was 13%.

摘要

94例患者(平均年龄48岁)共96处胫骨平台移位骨折接受了切开复位内固定治疗。术后12个月时,膝关节平均活动范围为126度,10例(10%)患者需要二次手术。使用二元回归模型,未发现年龄、性别、吸烟史、糖尿病、体重指数等人口统计学变量,或损伤机制、初始平台塌陷、Schatzker分类等骨折特征与并发症、活动范围、愈合时间或残余塌陷等短期功能结局相关。我们确定,初始移位较少的骨折在影像学上的复位并不更好,术后12个月时平台塌陷增加并不意味着功能下降。然而,发现术后关节台阶增加与平台塌陷风险增加相关(p<0.01)。此外,术后12个月时,76%的患者恢复了伤前工作,总体并发症发生率为13%。

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