Department of Orthopaedics, The Affiliated Hospital of Innermongolia Medical University, Hohhot, 010010, China.
Department of Orthopaedics, Beijing Chao-Yang Hospital, China Capital Medical University, Beijing, 100020, China.
BMC Musculoskelet Disord. 2020 Apr 13;21(1):229. doi: 10.1186/s12891-020-03274-6.
The objective of this study to evaluate prospectively the effectiveness of Schatzker type IV tibial plateau fractures involving posteromedial plane managed by combined lateral peripatellar and posteromedial approaches.
We analyzed 18 patients with Schatzker type IV tibial plateau fractures involving posteromedial plane. There were 12 males and 6 females with an average of 38.5 years (range, 25-60 years). The mechanism of injury included traffic accident in 15 patients and falling in 3 patients. The injured lower limbs were right in 11 patients and left in 7 patients. The mean time from injury to surgery was 6.78 days (range, 5-9 days). There were 8 patients with meniscus injuries in our study.
The mean operation time was 3.41 h (range, 3-4 h). The mean blood loss was 352.78 ml (range, 300-410 ml). All the injured meniscuses were repaired. All patients were followed up, and the average time of follow up was 16.61 months (range, 14-22 months). Bone union was achieved at a mean of 12 weeks (range, 10-14 weeks). The mean degree of knee extension was 1.11° (range, 0-5°), and the mean degree of knee flexion was 120.56° (range, 110-130°). The mean points of KSS were 83 (range, 74-89 points). According to the criteria of KSS, 14 patients had clinical outcomes rated as excellent and 4 patients were rated as good.
Our results suggested that Combined lateral peripatellar and posteromedial approaches in the treatment of Schatzker type IV tibial plateau fractures involving posteromedial plane acquired satisfying outcomes. It was good for repairing the injured meniscus through our approaches.
本研究旨在前瞻性评估采用外侧髌旁入路联合后内侧入路治疗涉及后内侧平面的 Schatzker Ⅳ型胫骨平台骨折的疗效。
我们分析了 18 例涉及后内侧平面的 Schatzker Ⅳ型胫骨平台骨折患者。男 12 例，女 6 例，平均年龄 38.5 岁（25-60 岁）。损伤机制包括交通事故 15 例，跌倒 3 例。受伤下肢右侧 11 例，左侧 7 例。从受伤到手术的平均时间为 6.78 天（5-9 天）。本研究中有 8 例半月板损伤。
手术时间平均 3.41 小时（3-4 小时）。平均失血量 352.78ml（300-410ml）。所有受伤的半月板均得到修复。所有患者均获得随访，平均随访时间 16.61 个月（14-22 个月）。骨愈合平均时间为 12 周（10-14 周）。膝关节伸直平均角度为 1.11°（0-5°），膝关节屈曲平均角度为 120.56°（110-130°）。膝关节功能评分（KSS）平均为 83 分（74-89 分）。根据 KSS 标准，14 例临床疗效评定为优，4 例评定为良。
采用外侧髌旁入路联合后内侧入路治疗涉及后内侧平面的 Schatzker Ⅳ型胫骨平台骨折疗效满意，通过我们的入路有利于修复受伤的半月板。
