Rabatsky Ali, Lockenour John D
Department of Life Sciences, Palmer College of Chiropractic Port Orange, Port Orange, Florida.
J Chiropr Med. 2018 Mar;17(1):63-67. doi: 10.1016/j.jcm.2017.11.003. Epub 2018 Jan 12.
The purpose of this case report was to describe the management of a tibial plateau fracture in a patient who had undergone anterior cruciate ligament (ACL) reconstruction 3.5 years earlier.
A 36-year-old man presented with pain and edema following a fall from a height of approximately 2 m while skateboarding. The patient reported having undergone arthroscopic ACL reconstruction with allograft and bioabsorbable screws 3.5 years earlier. Computed tomography scan revealed a comminuted fracture extending through the graft tunnel, as well as evidence of tunnel widening and incomplete bone resorption and generation within the tibial tunnel.
A trauma surgeon repaired the plateau fracture with internal fixation. The patient was non-weight bearing for 8 weeks while undergoing rehabilitation in a chiropractic clinic (spinal manipulation, physiotherapy, nutritional support) twice per week and returned to full activity within 3 months.
The patient responded favorably to the treatment protocol, which included rehabilitation by a doctor of chiropractic and co-management with a trauma surgeon.
本病例报告旨在描述一名3.5年前接受前交叉韧带（ACL）重建手术的患者胫骨平台骨折的治疗情况。
一名36岁男性在滑板时从约2米高处坠落，出现疼痛和水肿。患者报告3.5年前接受了同种异体移植和生物可吸收螺钉的关节镜下ACL重建手术。计算机断层扫描显示骨折粉碎并延伸至移植隧道，同时有隧道增宽以及胫骨隧道内骨吸收和再生不完全的迹象。
一名创伤外科医生通过内固定修复了平台骨折。患者在整脊诊所（脊柱推拿、物理治疗、营养支持）每周接受两次康复治疗，8周内不负重，并在3个月内恢复了完全活动能力。
患者对包括整脊医生康复治疗和与创伤外科医生共同管理的治疗方案反应良好。
