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胫骨平台前内侧大骨折合并孤立性膝后外侧角损伤:一种常被漏诊的不寻常损伤模式的病例系列

Large fracture of the anteromedial tibial plateau with isolated posterolateral knee corner injury: case series of an often missed unusual injury pattern.

作者信息

Tomás-Hernández Jordi, Monyart Joan Minguell, Serra Jordi Teixidor, Vinaixa Merce Reverté, Farfan Ernesto Guerra, García Vicente Molero, Feliu Enric Castellet

机构信息

Department of Orthopaedic and Trauma Surgery, Trauma Unit, Hospital Vall d'Hebron - Universitat Autonoma de Barcelona (UAB), Passeig Vall d'Hebron, Barcelona, Spain.

Department of Orthopaedic and Trauma Surgery, Knee Unit, Hospital Vall d'Hebron - Universitat Autonoma de Barcelona (UAB), Passeig Vall d'Hebron, Barcelona, Spain.

出版信息

Injury. 2016 Sep;47 Suppl 3:S35-S40. doi: 10.1016/S0020-1383(16)30604-0.

Abstract

Tibial plateau fractures are a heterogeneous group of lesions with multiple fracture patterns. They are often associated with soft tissue injuries, the lateral meniscus and the anterior cruciate ligament (ACL) being the most common structures affected. The purpose of this article is to present a case series of an often missed unusual injury pattern that consists on the association of a large anteromedial tibial plateau fracture with a posterolateral (PL) knee corner injury without involvement of the cruciate ligaments. The diagnosis of PL complex injury may go unrecognized in a considerable number of cases and delay on the treatment decreases the success rate of soft tissue repairing. The importance of a high index of suspicion and a proper early diagnosis with an MRI is of paramount importance. We also describe the current surgical management used by the authors and review of the current literature.

摘要

胫骨平台骨折是一组具有多种骨折类型的异质性损伤。它们常伴有软组织损伤,外侧半月板和前交叉韧带(ACL)是最常受影响的结构。本文的目的是介绍一系列经常被漏诊的不寻常损伤类型,即大型胫骨平台前内侧骨折与膝关节后外侧(PL)角损伤相关联,且不涉及交叉韧带。在相当多的病例中,PL复合体损伤可能未被识别,治疗延迟会降低软组织修复的成功率。高度的怀疑指数以及通过磁共振成像(MRI)进行恰当的早期诊断至关重要。我们还描述了作者目前采用的手术治疗方法并对当前文献进行了综述。

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