Cinats David J, Stone Trevor
Department of Orthopaedics, Royal Columbian Hospital, University of British Columbia, New Westminster, BC.
J Orthop Trauma. 2021 Feb 1;35(2):e66-e70. doi: 10.1097/BOT.0000000000001850.
Comminuted proximal fibula fractures or arcuate fractures (OTA/AO 4F1B fractures) can defunction the posterolateral corner (PLC) and result in posterolateral knee instability. Ongoing posterolateral knee instability can limit function, cause significant pain, and lead to early knee arthrosis. The anatomy of the PLC and proximal fibula limits the options for repair of this injury. The ideal method for osteosynthesis of these injuries has not been established. The goals of treatment include reconstitution of posterolateral stability, restoration of the anatomic relationship of PLC structures, and restoration of bone stock that would permit future reconstruction. This article characterizes the injury pattern, outlines the technique, and provides the clinical and radiographic outcomes of osteosynthesis of comminuted fibular head fractures using a novel application of the tension-slide technique.
腓骨近端粉碎性骨折或弓形骨折（OTA/AO 4F1B骨折）可导致后外侧角（PLC）功能丧失，并引起膝关节后外侧不稳定。持续的膝关节后外侧不稳定会限制功能、导致严重疼痛，并引发早期膝关节骨关节炎。PLC和腓骨近端的解剖结构限制了该损伤的修复选择。目前尚未确定这些损伤的理想接骨方法。治疗目标包括重建后外侧稳定性、恢复PLC结构的解剖关系，以及恢复骨量以允许未来的重建。本文描述了损伤模式，概述了技术，并提供了使用张力滑动技术的新应用对腓骨头粉碎性骨折进行接骨术的临床和影像学结果。
