Wang Jun, Wei Jie, Wang Manyi
Traumatology Department, Beijing Jishuitan Hospital, No. 31 East Street of Xin Jie Kou, Beijing, 100035, People's Republic of China,
Eur J Orthop Surg Traumatol. 2015 Jul;25(5):913-20. doi: 10.1007/s00590-015-1614-5. Epub 2015 Mar 8.
The goal of this study was to assess the incidence of soft tissue injury in the tibial plateau fracture by magnetic resonance image (MRI) and reveal the relationship between the articular widening/depression and the risk of meniscus and ligament disorder. A total of 54 patients with tibial plateau fracture were indicated for operative intervention. Soft tissue injuries were assessed by MRI. Meniscus, anterior/posterior cruciate ligaments and medial/lateral collateral ligaments injuries on MRI were evaluated. The articular widening/depression was measured in picture archiving and communication systems. Schatzker classification of fracture types was not significantly associated with soft tissue injuries. The rates of soft tissue injury in types IV and II (respectively, 85.7 and 74.1 %) were higher than those in other types. The meniscus injury was the most common soft tissue damage, and the incidence of meniscus injury was 55.6 %. When LPDCT and LPWCT were, respectively, about 7.6 mm and 10.1 mm and LPDX-ray and LPWX-ray, respectively, 5.6 and 7.4 mm, more attention should be paid on the collateral and cruciate ligament injuries in types I, II and III. Furthermore, when LPWCT and LPWX-ray were, respectively, about 10.3 and 8.6 mm, the collateral and cruciate ligaments were susceptible to injury in types IV and V. In conclusion, tibial plateau fracture can occur high morbidity of soft tissue injury, including meniscus and ligament disorder. X-ray and CT scan had different predicting standards for soft tissue injury, and the articular widening/depression in the tibial plateau was associated with meniscus and ligament injuries.
本研究的目的是通过磁共振成像（MRI）评估胫骨平台骨折中软组织损伤的发生率，并揭示关节增宽/凹陷与半月板和韧带损伤风险之间的关系。共有54例胫骨平台骨折患者接受手术干预。通过MRI评估软组织损伤情况。对MRI上的半月板、前后交叉韧带和内外侧副韧带损伤进行评估。在图像存档与通信系统中测量关节增宽/凹陷。骨折类型的Schatzker分类与软组织损伤无显著相关性。IV型和II型的软组织损伤发生率（分别为85.7%和74.1%）高于其他类型。半月板损伤是最常见的软组织损伤，半月板损伤发生率为55.6%。当LPDCT和LPWCT分别约为7.6 mm和10.1 mm，以及LPDX线和LPWX线分别为5.6和7.4 mm时，I、II和III型应更关注副韧带和交叉韧带损伤。此外，当LPWCT和LPWX线分别约为10.3和8.6 mm时，IV型和V型的副韧带和交叉韧带易发生损伤。总之，胫骨平台骨折可伴有较高的软组织损伤发生率，包括半月板和韧带损伤。X线和CT扫描对软组织损伤有不同的预测标准，胫骨平台的关节增宽/凹陷与半月板和韧带损伤相关。
