关节镜辅助评估手术治疗胫骨平台骨折中半月板撕裂的频率和类型：一项回顾性研究。
Arthroscopically assisted evaluation of frequency and patterns of meniscal tears in operative tibial plateau fractures: a retrospective study.
机构信息
School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.
Department of Orthopedics, The Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China.
出版信息
J Orthop Surg Res. 2021 Feb 6;16(1):117. doi: 10.1186/s13018-021-02265-0.
BACKGROUND
Despite tibial plateau fractures are often associated with meniscal tears, the association between meniscal tears and Schatzker classification remains unclear. The purpose of this study was to assess the frequency and patterns of meniscal tears in operatively treated tibial plateau fractures following immediate arthroscopic evaluation after internal fixation of tibial plateau fractures and to reveal the association between these concomitant meniscal tears and Schatzker classification.
METHODS
A total of 252 consecutive patients (166 males and 86 females, mean age 46.7 (19-80) years) with operatively treated tibial plateau fractures admitted to our hospital from January 2016 to May 2019 were performed. Arthroscopic examination for frequency and patterns of meniscal tears was evaluated and documented at the time of surgery, and the association between the frequency and patterns of meniscal tears with Schatzker classification was then analyzed.
RESULTS
The overall frequency of meniscal tears in TPFs was 67% (168 of 252) with 33% (84 of 252) of these being lateral meniscal tears, and 10% (26 of 252) medial meniscal tears, while 23% (58 of 252) had bilateral meniscal tears. Schatzker II was most commonly associated with meniscal tears, occurring in 72% (71 of 99) of our series. There is no significant difference between the frequency of meniscal tears and Schatzker classification (p > 0.05). The most common patterns of meniscal tears were longitudinal tears in 23% of tibial plateau fractures (59 of 252), and it occurred at a significantly higher frequency in Schatzker II with 43% (43 of 99). Schatzker IV had significantly higher prevalence of bucket-handle tears than other fracture patterns (p < 0.05), and Schatzker VI fractures had significantly higher prevalence of complex tears than other fracture patterns (p < 0.05). For other Schatzker classification, the patterns of meniscal tears demonstrated no statistical difference (p > 0.05).
CONCLUSION
The results identified that meniscal tears are commonly seen in each Schatzker classification. Although various patterns of meniscal tears occurred in tibial plateau fractures, the most common patterns were longitudinal tears. Importantly, we suggest that the status of meniscal tears associated with TPFs should be considered at the time of surgery in addition to fracture fixation.
背景
尽管胫骨平台骨折常伴有半月板撕裂，但半月板撕裂与 Schatzker 分类之间的关系尚不清楚。本研究的目的是评估在胫骨平台骨折内固定后立即进行关节镜检查时，手术治疗的胫骨平台骨折患者中半月板撕裂的频率和模式，并揭示这些伴随的半月板撕裂与 Schatzker 分类之间的关系。
方法
本研究纳入了 2016 年 1 月至 2019 年 5 月期间我院收治的 252 例（男 166 例，女 86 例，平均年龄 46.7[19-80]岁）接受手术治疗的胫骨平台骨折患者。在手术时评估并记录半月板撕裂的频率和模式，并分析半月板撕裂的频率和模式与 Schatzker 分类之间的关系。
结果
胫骨平台骨折患者半月板撕裂的总发生率为 67%（252 例中的 168 例），其中外侧半月板撕裂占 33%（84 例），内侧半月板撕裂占 10%（26 例），双侧半月板撕裂占 23%（58 例）。Schatzker II 型与半月板撕裂最常见，在本研究系列中占 72%（71 例）。半月板撕裂的频率与 Schatzker 分类之间无显著差异（p＞0.05）。半月板撕裂最常见的模式是胫骨平台骨折中的纵向撕裂，占 23%（59 例），在 Schatzker II 型中发生率明显更高，为 43%（43 例）。Schatzker IV 型的桶柄状撕裂明显多于其他骨折类型（p＜0.05），Schatzker VI 型骨折的复杂撕裂明显多于其他骨折类型（p＜0.05）。对于其他 Schatzker 分类，半月板撕裂的模式无统计学差异（p＞0.05）。
结论
结果表明，半月板撕裂在每个 Schatzker 分类中都很常见。尽管胫骨平台骨折中存在多种半月板撕裂模式，但最常见的模式是纵向撕裂。重要的是，我们建议在手术时除了固定骨折外，还应考虑胫骨平台骨折患者的半月板撕裂情况。
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