Kayali Cemil, Citak Caner, Altay Taskin, Kement Zafer
Bozyaka Education and Teaching Hospital Orthopaedics and Traumatology Clinics, Karabaglar Izmir, Turkey.
Acta Ortop Bras. 2017 May-Jun;25(3):99-102. doi: 10.1590/1413-785220172503153742.
To evaluate the functional and radiological results of Schatzker type II fractures treated via subchondral raft screws combined with locking plates.
Twenty-four individuals were enrolled in this study between 2010 and 2014. The depressed joint line was elevated and the defect was filled with allograft. Next, two or three subchondral screws were placed in combination with a locking plate. At the last follow-up, clinical and radiological data were recorded.
The mean follow-up period was 21.4 months (12-39). The mean Knee Society Score (KSS) and Rasmussen clinical scores were 91.5 (range, 77-100) and 16.75 (range, 14-18), respectively. The mean Rasmussen radiological score was 27.9 (range, 24-30) during the follow-up. There was no statistically significant difference between injured and non-injured sides with respect to the mechanical axis, the proximal medial tibial angle, and tibial slope. In addition, arthritis showed no difference on the non-injured side, although follow-up was short.
The periarticular raft construction combined with the locking plate helps surgeon to maintain the anatomic line of the joint and the mechanical axis obtained during the surgery. Secondary arthritis seems to be major complication after fractures of the tibial plateau, although the functional results were satisfactory.
评估采用软骨下骨块螺钉联合锁定钢板治疗Schatzker II型骨折的功能和影像学结果。
2010年至2014年期间，24例患者纳入本研究。抬高塌陷的关节线，并用同种异体骨填充缺损。接下来，置入2或3枚软骨下螺钉并联合锁定钢板。在末次随访时，记录临床和影像学数据。
平均随访时间为21.4个月（12 - 39个月）。平均膝关节协会评分（KSS）和拉斯穆森临床评分分别为91.5（范围77 - 100）和16.75（范围14 - 18）。随访期间平均拉斯穆森影像学评分为27.9（范围24 - 30）。患侧与未患侧在机械轴、胫骨近端内侧角和胫骨坡度方面无统计学显著差异。此外，尽管随访时间短，但未患侧的关节炎情况无差异。
关节周围骨块结构联合锁定钢板有助于外科医生在手术中维持关节的解剖线和机械轴。尽管功能结果令人满意，但继发性关节炎似乎是胫骨平台骨折后的主要并发症。
