Zheng Zhan-le, Yu Yi-Yang, Chang Heng-Rui, Liu Huan, Zhou Hui-Lin, Zhang Ying-Ze
Department of Orthopaedic Trauma Center, Key Biomechanics Lab of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Orthop Surg. 2019 Feb;11(1):97-101. doi: 10.1111/os.12424. Epub 2019 Feb 8.
The purpose of this retrospective study was to determine the incidence of fibular fractures as an associated injury in tibial plateau fractures according to CT scan. We also attempt to introduce a new morphological sub-classification on this associated injury and to analyze the correlation between this classification and tibial plateau fractures.
We selected cases with fibular fractures from all the tibial plateau fracture patients. The cases were further divided into 2 groups: unicondylar group and bicondylar group. On the basis of our new classification system of fibular fracture, all the included cases were divided into 5 subgroups.
Finally, a total of 150 cases associated with fibular fractures in 502 tibial plateau fracture cases were identified from our institution database. The incidence of fibular head fracture in tibial plateau fractures was 29.88% (150/502). Seventy-one cases (47.3%) were involved one condyle, and 79 cases (52.7%) involved both. It shows significant difference in the subgroup of avulsion fracture with horizontal fracture line (Type A) which is ratio of 16.9% in unicondylar group and 1.27% in bicondylar group.
A new classification of this associated injury describing the morphology of the fracture fragments may improve operative planning.
本回顾性研究的目的是根据CT扫描确定腓骨骨折作为胫骨平台骨折相关损伤的发生率。我们还试图对这种相关损伤引入一种新的形态学亚分类，并分析这种分类与胫骨平台骨折之间的相关性。
我们从所有胫骨平台骨折患者中选取伴有腓骨骨折的病例。这些病例进一步分为两组：单髁组和双髁组。根据我们新的腓骨骨折分类系统，将所有纳入病例分为5个亚组。
最终，从我们机构的数据库中确定了502例胫骨平台骨折病例中有150例伴有腓骨骨折。胫骨平台骨折中腓骨头骨折的发生率为29.88%（150/502）。71例（47.3%）累及一个髁，79例（52.7%）累及两个髁。在伴有水平骨折线的撕脱骨折亚组（A型）中存在显著差异，单髁组的比例为16.9%，双髁组为1.27%。
这种描述骨折碎片形态的相关损伤的新分类可能会改善手术规划。
