Bertrand Maria L, Pascual-López F Javier, Guerado Enrique
Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Spain.
Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Spain.
Injury. 2017 Nov;48 Suppl 6:S81-S85. doi: 10.1016/S0020-1383(17)30799-4.
Tibial plateau fractures (TPF) are highly prone to complications and adverse effects. Their treatment has long been a matter of controversy, as fracture patterns and possible damage to soft tissues can easily aggravate complications. On the one hand, open reduction and internal fixation (ORIF) techniques provide a good approach to joint shape restoration and biomechanics, but they may also provoke a higher rate of soft-tissue complications. On the other, hybrid external fixation (HEF), although allowing little facility for reduction, may, theoretically, produce much less damage to the soft tissues. We present 93 cases of TPF classified as type V or VI that were followed up for at least 24 months. There were no statistical differences among them in relation to consolidation, secondary malalignment or range of motion, according to whether ORIF or HEF was employed. However, when external fixation followed open reduction, both superficial and deep-infection rates were higher.
胫骨平台骨折（TPF）极易引发并发症和不良影响。其治疗长期以来一直存在争议，因为骨折类型以及软组织可能受到的损伤很容易加重并发症。一方面，切开复位内固定（ORIF）技术为关节形态恢复和生物力学提供了良好的方法，但也可能引发更高的软组织并发症发生率。另一方面，混合外固定（HEF）虽然复位难度较大，但从理论上讲，对软组织的损伤可能要小得多。我们报告了93例V型或VI型TPF病例，这些病例至少随访了24个月。根据采用的是ORIF还是HEF，在骨折愈合、继发性畸形或活动范围方面，它们之间没有统计学差异。然而，当切开复位后采用外固定时，浅表和深部感染率都更高。
