Xiang Gao, Zhi-Jun Pan, Qiang Zheng, Hang Li
Orthopedics. 2013 Oct 1;36(10):e1256-61. doi: 10.3928/01477447-20130920-16.
Treatment of posterolateral tibial plateau fractures is controversial, and information regarding this specific fracture pattern is lacking. The purpose of this study was to elucidate the frequency and morphological features of posterolateral articular fragments in tibial plateau fractures. A retrospective radiographic and chart review was performed on a consecutive series of patients who sustained tibial plateau fractures between May 2008 and August 2012. The articular surface area, maximum posterior cortical height, sagittal fracture angle, and amount of displacement were measured on computed tomography scans using the Picture and Archiving Communication System. Thirty-six (15%) of 242 injuries demonstrated a posterolateral fracture fragment comprising a mean 14.3% of the articular surface of the total tibial plateau (range, 8% to 32%). Mean major articular fragment angle was 23° (range, 62° to -43°), mean maximum posterior cortical height was 29 mm (range, 18 to 42 mm), and mean sagittal fracture angle was 77° (range, 58° to 97°). The posterolateral plateau articular fracture fragment has morphological characteristics of a conically shaped fragment with a relatively small articular surface area and sagittal fracture angle. Recognizing these morphological features will help the clinician formulate an effective surgical plan.
胫骨平台后外侧骨折的治疗存在争议，且缺乏关于这种特定骨折类型的信息。本研究的目的是阐明胫骨平台骨折后外侧关节碎片的发生率及形态特征。对2008年5月至2012年8月期间连续收治的胫骨平台骨折患者进行了回顾性影像学和病历审查。使用图像存档与通信系统在计算机断层扫描上测量关节表面积、最大后皮质高度、矢状骨折角度和移位量。242例损伤中有36例（15%）出现后外侧骨折碎片，占胫骨平台总关节面的平均比例为14.3%（范围为8%至32%）。主要关节碎片的平均角度为23°（范围为62°至 -43°），最大后皮质高度平均为29 mm（范围为18至42 mm），矢状骨折角度平均为77°（范围为58°至97°）。胫骨平台后外侧关节骨折碎片具有关节表面积相对较小且矢状骨折角度的锥形碎片的形态特征。认识到这些形态特征将有助于临床医生制定有效的手术计划。
