Zhang Shimin, Hu Sunjun, Du Shouchao, Ma Zhuo
Department of Orthopedics, Yangpu Hospital, Tongji University, Shanghai, 200090,
Department of Orthopedics, Yangpu Hospital, Tongji University, Shanghai, 200090, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Apr 15;32(4):495-500. doi: 10.7507/1002-1892.201707070.
To summarize the progress in the treatment of hyperextension tibial plateau fractures.
Related literature concerning hyperextension tibial plateau fractures was reviewed and analyzed in terms of injury mechanisms, clinical patterns, and treatment outcomes.
Hyperextension tibial plateau fractures is a specific type of hyperextension knee injuries, which is happened with the knee in over-extended position (<0°) and characterized by fracture and concomitant ligament injury. It can be classified into 4 patterns: marginal avulsion fractures, unicondylar anteromedial fractures, anterolateral fractures, and bicondylar fractures. The failure of structures occurs according to the diagonal injury mechanism characterized by anterior compression fractures and posterior tension ruptures. It is noted as a rule that a smaller anterior fragment is more likely to accompany by a posterior ligament rupture. Unicondylar anteromedial fracture pattern is caused by hyperextension varus mechanism and usually accompanied by posterolateral corner rupture. Bicondylar hyperextension injury is characterized by posterior metaphyseal cortical tension rupture, anterior articular depression, and reversed posterior slope.
Currently there is no consensus on the treatment of hyperextension tibial plateau fractures. Further basic and clinical studies are needed.
总结胫骨平台后伸型骨折的治疗进展。
回顾并分析有关胫骨平台后伸型骨折的相关文献，内容涉及损伤机制、临床类型及治疗结果。
胫骨平台后伸型骨折是膝关节后伸损伤的一种特殊类型，发生于膝关节过度伸展位（<0°），以骨折并伴有韧带损伤为特征。可分为4种类型：边缘撕脱骨折、单髁前内侧骨折、前外侧骨折和双髁骨折。结构破坏按照以前方压缩骨折和后方张力断裂为特征的对角线损伤机制发生。通常规律是较小的前方骨折块更易伴有后方韧带断裂。单髁前内侧骨折类型由后伸内翻机制引起，常伴有后外侧角破裂。双髁后伸损伤的特征为后方干骺端皮质张力断裂、前方关节面凹陷及后倾坡度反转。
目前对于胫骨平台后伸型骨折的治疗尚无共识。需要进一步开展基础和临床研究。
