Sevencan Ahmet, Şenol Mehmet Selçuk, Mısır Abdulhamit, Aycan Osman Emre, Albayrak Akif, Uçpunar Hanifi
Department of Orthopedics and Traumatology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey.
Jt Dis Relat Surg. 2020;31(1):130-6. doi: 10.5606/ehc.2020.66654.
This study aims to compare the clinical and radiological outcomes of the two fixation methods frequently used in the treatment of Schatzker type II fractures: lag screw fixation and lateral anatomic plate fixation.
This retrospective study, which was conducted between January 2005 and December 2014, included 61 patients (41 males, 20 females; mean age 43.4±13.1 years; range, 20 to 76 years) with Schatzker type II (Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) 41-B3) fractures. Patients were divided into two groups according to the type of surgery as cannulated lag screw fixation group (group 1, n=24, 39.4%) and lateral locking plate fixation group (group 2, n=37, 60.6%). Intraoperative mediolateral and anteroposterior instability were measured. Final knee flexion- extension range of motion (ROM), single-leg hop test, Knee Society Score (KSS), Hospital for Special Surgery (HSS) and short form 36 (SF36) scores were obtained at the last follow-up.
The mean age of patients was 42.1±13.8 years in group 2 and 45.5±12.2 years in group 1. The mean follow-up period was 34±4 months. Minimal or no arthritis was detected in 75% (n=18) of patients in group 1 and 78% (n=29) of patients in group 2 (p=0.27). Single leg-hop test results (p=0.55), final follow-up knee ROM (p=0.40), KSS (p=0.21), HSS (p=0.15), and SF36 scores of group 1 were similar to group 2. In group 1, the duration of surgery was shorter (p<0.001) and the cost of treatment was lower (p<0.001).
Treatment of Schatzker type II tibial plateau fractures with lag screws seems to provide less invasive, cheaper, and faster surgical treatment as compared with lateral locking plate fixation. In addition, patients who underwent internal fixation with lag screws had similar clinical and radiological outcomes with those who underwent lateral locking plate fixation.
本研究旨在比较治疗Schatzker II型骨折常用的两种固定方法的临床和影像学结果：拉力螺钉固定和外侧解剖钢板固定。
本回顾性研究于2005年1月至2014年12月进行，纳入61例Schatzker II型（骨科创伤协会（OTA）/骨科学术研究协会（AO）41 - B3）骨折患者（41例男性，20例女性；平均年龄43.4±13.1岁；范围20至76岁）。根据手术类型将患者分为两组，即空心拉力螺钉固定组（第1组，n = 24，39.4%）和外侧锁定钢板固定组（第2组，n = 37，60.6%）。术中测量内外侧和前后向不稳定情况。在末次随访时获取最终膝关节屈伸活动范围（ROM）、单腿跳测试、膝关节协会评分（KSS）、特种外科医院（HSS）评分和简明健康状况调查量表（SF36）评分。
第2组患者的平均年龄为42.1±13.8岁，第1组为45.5±12.2岁。平均随访时间为34±4个月。第1组75%（n = 18）的患者和第2组78%（n = 29）的患者检测到轻微或无关节炎（p = 0.27）。第1组的单腿跳测试结果（p = 0.55）、末次随访时膝关节ROM（p = 0.40）、KSS（p = 0.21）、HSS（p = 0.15）和SF36评分与第2组相似。在第1组中，手术时间较短（p < 0.001）且治疗费用较低（p < 0.001）。
与外侧锁定钢板固定相比，用拉力螺钉治疗Schatzker II型胫骨平台骨折似乎能提供侵入性更小、成本更低且速度更快的手术治疗。此外，接受拉力螺钉内固定的患者与接受外侧锁定钢板固定的患者具有相似的临床和影像学结果。
