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3.5毫米解剖锁定钢板治疗累及干骺端交界的胫骨近端骨折的疗效

Outcome of 3.5-mm Anatomical Locking Plates for the Treatment of Proximal Tibia Fractures Involving the Meta-Diaphyseal Junction.

作者信息

Lee Jin Kyu, Choi Won Rak, Lee Jae-Ho, Hwang Kyu-Tae

出版信息

Orthopedics. 2018 Nov 1;41(6):e777-e782. doi: 10.3928/01477447-20180912-01. Epub 2018 Sep 18.

Abstract

The clinical and radiological outcomes of proximal tibia fractures involving the meta-diaphyseal junction treated with unilateral 3.5-mm locking precontoured anatomical plates are reported. Thirty-nine patients (41 proximal tibia fractures) who had proximal tibia fractures with complete meta-diaphyseal dissociation were enrolled in the study. For all patients, immediate postoperative and final follow-up simple radiographs were evaluated to determine the quality of the reduction by assessing coronal and sagittal alignment. In cases of intra-articular involvement, articular reduction quality and condylar width were additionally assessed. Clinical outcomes were assessed by knee range of motion and Lysholm knee score at final follow-up. Immediate postoperative radiographs showed satisfactory results: medial proximal tibial angle within 87°±5° in 87.8% (36 of 41), posterior tibia slope within 9°±5° in 85.4% (35 of 41), less than 2-mm articular step or gap in 79.3% (23 of 29), and a condylar width difference within 5 mm compared with the femoral condyles in 93.1% (27 of 29). All reductions but 1 were found to have satisfactory maintenance of the initial reduction. At final follow-up, the mean knee range of motion and Lysholm knee score were 122.5° (range, 100°-135°) and 75.8 (range, 50-100), respectively. A single lateral 3.5-mm plate fixation for proximal tibia fractures involving the meta-diaphyseal junction offers mechanically stable fixation with satisfactory clinical and radiological outcomes. [Orthopedics. 2018; 41(6):e777-e782.].

摘要

报告了采用单侧3.5毫米锁定预塑形解剖钢板治疗累及干骺端交界的胫骨近端骨折的临床和放射学结果。本研究纳入了39例(41处胫骨近端骨折)胫骨近端骨折且干骺端完全分离的患者。对所有患者,术后即刻和末次随访时的简单X线片进行评估,通过评估冠状面和矢状面的对线情况来确定复位质量。对于累及关节内的病例,还额外评估关节复位质量和髁宽度。在末次随访时通过膝关节活动范围和Lysholm膝关节评分评估临床结果。术后即刻X线片显示结果满意:87.8%(41例中的36例)胫骨近端内侧角在87°±5°以内,85.4%(41例中的35例)胫骨后倾斜率在9°±5°以内,79.3%(29例中的23例)关节台阶或间隙小于2毫米,93.1%(29例中的27例)与股骨髁相比髁宽度差异在5毫米以内。除1例之外,所有复位均发现对初始复位维持良好。在末次随访时,膝关节平均活动范围和Lysholm膝关节评分分别为122.5°(范围100°-135°)和75.8(范围50-100)。对于累及干骺端交界的胫骨近端骨折,采用单块外侧3.5毫米钢板固定可提供机械稳定的固定,临床和放射学结果满意。[《骨科学》。2018年;41(6):e777-e782。]

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