Jensen D B, Bjerg-Nielsen A, Laursen N
Department of Orthopedics, Glostrup University Hospital, Denmark.
Skeletal Radiol. 1988;17(5):330-2. doi: 10.1007/BF00367177.
Seventy patients with 72 conservatively treated tibial plateau fractures were re-examined after an average of 5 3/4 years. Among 55 fractured knees with a primary articular depression of 1-20 mm, the depression was still present radiographically in 47 knees. No correlation existed between the persistent radiographic depression and function of the knee. Moderate to severe osteoarthrosis was found in 10 knees; in five of these the osteoarthrosis was of clinical importance. More than 10 degrees of valgus/varus deformity was present in two knees. In two patients osteotomy had been performed to correct deformity. It is concluded that a persistent radiographic articular depression is of no clinical importance in tibial plateau fractures treated by conservative methods, which include early movement of the knee. The radiographic examination, however is, useful in the evaluation of valgus/varus deformity and osteoarthrosis.
70例经保守治疗的72处胫骨平台骨折患者在平均5又3/4年后接受了复查。在55例初次关节面塌陷1 - 20毫米的骨折膝关节中,47例膝关节在X线片上仍存在塌陷。X线片上持续存在的塌陷与膝关节功能之间不存在相关性。10例膝关节发现中度至重度骨关节炎;其中5例的骨关节炎具有临床意义。2例膝关节存在超过10度的外翻/内翻畸形。2例患者接受了截骨术以纠正畸形。得出的结论是,在采用包括早期膝关节活动在内的保守方法治疗的胫骨平台骨折中,X线片上持续存在的关节面塌陷并无临床意义。然而,X线检查在评估外翻/内翻畸形和骨关节炎方面是有用的。