Ollivier Matthieu, Turati Marco, Munier Maxime, Lunebourg Alexandre, Argenson Jean-Noel, Parratte Sebastien
Department of Orthopaedic Surgery, APHM, Institut du mouvement et de l'appareil locomoteur, Sainte-Marguerite Hospital, 13009, Marseille, France.
CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France.
Int Orthop. 2016 Sep;40(9):1961-6. doi: 10.1007/s00264-015-3047-5. Epub 2015 Nov 14.
In vitro studies have shown promising results for balloon-guided inflation tibioplasty. It was our hypothesis that this technique may be safe and effective for use in depressed lateral tibial plateau fracture.
We performed a prospective study of all patients suffering from a depressed lateral tibial plateau fracture, managed in our institution with inflation tibioplasty and a resorbable calcium phosphate bone substitute injection, between January 2012 and December 2013. Twenty patients, mean age 54.3 ± 12. 8 years, suffering from a depressed lateral tibial plateau fracture (Schatzker type II and III) were included. We then aimed to evaluate at a minimum follow-up of one year: (1) the rate of complications, (2) the clinical outcome (Knee Injury and Osteoarthritis Outcome (KOO) and 12-Item Short Form Health Survey (SF-12) scores); and (3) the radiographic outcome (evaluated by CT-scan).
No peri-operative complications occurred. In one patient, calcium phosphate substitute was found in the infrapatellar fat pad on post-operative radiography with no clinical or radiographic consequences at one year. At one year after surgery, the KOO subscores were: Pain 80 (range 64-93), other symptoms 81.3 (69-93), daily living activities 81.9 (46-99), sport 65.83 (20-100), and quality of life 67.04 (31-100). The SF-12 activity component was 40.4 (28.6-52.2) and SF-12 mental component 47.71 (28 - 67.1). The mean depressed step-off of the lateral joint decreased from 10.7 ± 4.8 mm pre-operatively to 2.7 ± 1.7 mm post-operatively (p < 0.0001).
Our observations suggest that the use of balloon-guided inflation tibioplasty with injection of a resorbable bone substitute is safe, and results in a high rate of anatomic reduction and good clinical outcomes in patients with depressed tibial plateau fractures.
Therapeutic Level IV.
体外研究已显示球囊引导下充气胫骨成形术有良好效果。我们的假设是，该技术用于治疗胫骨外侧平台凹陷骨折可能是安全有效的。
我们对2012年1月至2013年12月间在我院接受充气胫骨成形术及可吸收磷酸钙骨替代物注射治疗的所有胫骨外侧平台凹陷骨折患者进行了一项前瞻性研究。纳入了20例平均年龄为54.3±12.8岁的胫骨外侧平台凹陷骨折（Schatzker II型和III型）患者。然后，我们旨在进行至少一年的随访评估：（1）并发症发生率；（2）临床结果（膝关节损伤和骨关节炎结果（KOO）及12项简短健康调查（SF-12）评分）；以及（3）影像学结果（通过CT扫描评估）。
未发生围手术期并发症。1例患者术后X线片显示髌下脂肪垫中有磷酸钙替代物，但一年后无临床或影像学后果。术后一年，KOO子评分如下：疼痛80（范围64 - 93），其他症状81.3（69 - 93），日常生活活动81.9（46 - 99），运动65.83（20 - 100），生活质量67.04（31 - 100）。SF-12活动部分为40.4（28.6 - 52.2），SF-12心理部分为47.71（28 - 67.1）。外侧关节平均凹陷台阶术前为10.7±4.8mm，术后降至2.7±1.7mm（p < 0.0001）。
我们的观察结果表明，使用球囊引导下充气胫骨成形术并注射可吸收骨替代物是安全的，且能使胫骨平台凹陷骨折患者获得较高的解剖复位率和良好的临床结果。
治疗性IV级。
