Wu Jianbin, Wang Yiyang, Zhou Feiya, Yang Lei, Tang Jun
Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Western Road, Wenzhou, Zhejiang Province, PR China.
Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Western Road, Wenzhou, Zhejiang Province, PR China.
Injury. 2018 Feb;49(2):382-385. doi: 10.1016/j.injury.2017.11.015. Epub 2017 Nov 16.
There is no guideline and consensus about when and how to treat accompanying multi-ligaments injuries, especially anterior and/or posterior cruciate ligaments, in tibial plateau fractures. We report one case of fracture and dislocation of tibial plateau, treated by open reduction and internal plates fixation, augmented by trans-articular Kirschner wire fixation to overcome instability and malrotation of the knee joints discovered intraoperatively. The Kirschner wire was removed about four weeks after the index operation, and the patient begun functional exercise from then on. The fracture united uneventfully, the knee joint regained full range of motion without malalignment. The patient reported excellent knee function and satisfied with the operations. We suppose that trans-articular Kirschner wires fixation combined with open reduction internal plates fixation maybe is a treatment solution in treating complex tibial plateau fractures complicated by multiple ligamentous injuries.
对于胫骨平台骨折时如何以及何时治疗伴随的多韧带损伤,尤其是前交叉韧带和/或后交叉韧带损伤,目前尚无指南和共识。我们报告1例胫骨平台骨折并脱位的病例,采用切开复位内固定钢板治疗,并通过经关节克氏针固定来克服术中发现的膝关节不稳定和旋转不良。在初次手术后约4周取出克氏针,患者从那时开始进行功能锻炼。骨折顺利愈合,膝关节恢复了全范围活动且无畸形。患者报告膝关节功能良好,并对手术满意。我们认为经关节克氏针固定联合切开复位内固定钢板可能是治疗合并多发韧带损伤的复杂胫骨平台骨折的一种治疗方案。