Jagdev Saranjeet Singh, Pathak Subodh, Kanani Himanshu, Salunke Abhijeet
Research performed at Pramukhswami Medical College and Shree Krishna Hospital, Karamsad, Anand, India.
Department of Orthopaedics, Pramukhswami Medical College Karamsad, Anand, Gujarat, India.
Arch Bone Jt Surg. 2018 Nov;6(6):508-516.
In the challenging tibial condyle fractures despite anatomical joint reconstruction, development of osteoarthritis may still occur secondary to the initial articular cartilage and meniscal injury. The aim of the study was to know incidence of osteoarthritis in our operated cases of tibial plateau fracture and to evaluate functional outcome.
Our operated 60 patients of tibial plateau fractures between 2006 to 2013 were evaluated retrospectively. Pre-operative radiographs were classified using Schatzker classification. Patients were followed up clinically and radiologically and were assessed for functional outcome and development of osteoarthritis.
The average duration of follow up was 76.32 months ranging from 42 to 130 months. The average age was 41.28 (20-73) years. According to Schatzker classification type VI accounted for 32.5% and type V for 20 %. Average VAS Score was 1.35 ranging from 0 to 4. According to American knee society scoring system, 47patients had excellent and 8 patients had good knee scores, while 52 patients had excellent, 4 patients had good and 1 patient had poor functional scores. According to Ahlback classification 25 patients had grade I, while 9 patients had grade II, 7 patients had grade III and 3 patients had grade IV osteoarthritis of knee.
Incidence of osteoarthritis goes higher with Schatzker's grading. Despite presence of radiological arthritis patients can have good clinical function if the articular reduction and limb alignment are maintained. Treatment goals should include a congruent articular reduction, adequate knee stability, anatomical limb alignment and avoidance of complications.
IV.
在具有挑战性的胫骨髁骨折中，尽管进行了解剖学关节重建，但由于最初的关节软骨和半月板损伤，骨关节炎仍可能继发出现。本研究的目的是了解我们手术治疗的胫骨平台骨折病例中骨关节炎的发生率，并评估功能结果。
回顾性评估我们在2006年至2013年间手术治疗的60例胫骨平台骨折患者。术前X线片采用Schatzker分类法进行分类。对患者进行临床和影像学随访，并评估其功能结果和骨关节炎的发生情况。
平均随访时间为76.32个月，范围为42至130个月。平均年龄为41.28岁（20 - 73岁）。根据Schatzker分类，VI型占32.5%，V型占20%。平均视觉模拟评分（VAS）为1.35，范围为0至4。根据美国膝关节协会评分系统，47例患者膝关节评分优秀，8例患者评分良好，而52例患者功能评分优秀，4例患者评分良好，1例患者评分较差。根据Ahlback分类，25例患者膝关节骨关节炎为I级，9例为II级，7例为III级，3例为IV级。
骨关节炎的发生率随Schatzker分级升高。尽管存在放射性关节炎，但如果维持关节复位和肢体对线，患者仍可具有良好的临床功能。治疗目标应包括关节面的完全复位、足够的膝关节稳定性、肢体解剖学对线以及避免并发症。
IV级
