Wang Yanqing, Cao Fujiang, Liu Minghui, Wang Jiantao, Jia Shikong
Department of Orthopedic Surgery, Tianjin Union Medical Center, Tianjin, China.
Department of Orthopedic Surgery, Tianjin Medical University General Hospital, Tianjin, Tianjin, China.
J Knee Surg. 2016 Aug;29(6):451-7. doi: 10.1055/s-0036-1581132. Epub 2016 May 16.
Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures.
目的 本研究的目的是确定胫骨平台后外侧骨折患者软组织损伤的发生率。方法 回顾性分析2009年5月至2014年8月期间265例胫骨平台后外侧骨折患者的数据，使用图像存档与通信系统。骨折根据Schatzker、AO/OTA和象限分类系统进行分类。利用磁共振成像（MRI）数据评估软组织损伤，包括前交叉韧带（ACL）、后交叉韧带（PCL）、外侧副韧带（LCL）、内侧副韧带（MCL）、外侧半月板和内侧半月板损伤。结果 ACL和PCL撕裂的总体发生率分别为80%和36%。9例（36%）患者发生ACL止点撕脱，3例（12%）发生ACL完全撕裂。共有19例（76%）患者发生LCL损伤，15例（64%）发生MCL损伤。外侧半月板撕裂的发生率为48%，而内侧半月板撕裂的发生率为4%。结论 胫骨平台后外侧骨折与软组织损伤的高发生率相关，尤其是ACL止点撕脱和外侧半月板撕裂。术前MRI检查对外科医生决定韧带和半月板损伤是否应与骨折修复同时治疗很重要。
