Jiang Liangjun, Wu Haobo, Yan Shigui
Orthopaedics, The 2nd Affiliated Hospital, Medical College, Zhejiang University, Jiefang Road, No. 88, Hangzhou, Zhejiang, China.
Case Rep Orthop. 2015;2015:250487. doi: 10.1155/2015/250487. Epub 2015 Jul 8.
Background. The combined occurrence of ACL rupture with a posterolateral tibial plateau fracture has not yet been reported. Two cases of such injuries have been treated in our department for the past three years. Findings. The two patients both suffered injuries from traffic accidents. The radiological examinations showed a ruptured ACL with fracture of the posterolateral tibial plateau. Reconstruction of the ACL was performed via a standard anatomical single bundle ACL reconstruction technique with autologous tendon by arthroscopy. A posterolateral tibia plateau approach was used to reduce and fix the fractured area with the aid of lag screws. After a one-year follow-up, the two patients recovered well and physical examinations showed full knee range of motion with no evidence of ACL instability. Conclusions. The cause of this type injury of ACL rupture with a posterolateral tibial plateau fracture was thought to be by a violent internal tibial rotation/anterior tibial translation without any valgus or varus knee force mechanism during the accident. Satisfactory clinical results were achieved with a standard anatomical single bundle ACL reconstruction by arthroscopy and ORIF for the posterolateral plateau fracture. Both patients reported excellent knee function and fracture healing.
背景。前交叉韧带(ACL)断裂合并胫骨后外侧平台骨折的情况尚未见报道。在过去三年中,我们科室治疗了两例此类损伤患者。
病例发现。两名患者均因交通事故受伤。影像学检查显示ACL断裂合并胫骨后外侧平台骨折。通过关节镜采用标准解剖单束ACL重建技术,使用自体肌腱进行ACL重建。采用胫骨后外侧平台入路,借助拉力螺钉复位并固定骨折部位。经过一年的随访,两名患者恢复良好,体格检查显示膝关节活动范围正常,无ACL不稳定迹象。
结论。ACL断裂合并胫骨后外侧平台骨折这种损伤类型的原因被认为是在事故中胫骨发生暴力内旋/胫骨前移,而无任何膝关节外翻或内翻受力机制。通过关节镜下标准解剖单束ACL重建及后外侧平台骨折切开复位内固定术(ORIF)取得了满意的临床效果。两名患者均报告膝关节功能良好且骨折愈合。