Department of Osteoarthritis and Sport Surgery, Grenoble-Alpes CHU, South Teaching Hospital, Kimberley Avenue, BP 338 38434, Échirolles Cedex, France.
Grenoble-Alpes Medical Faculty, Service de Chirurgie Orthopédique, CHU Grenoble-Alpes site de Voiron, Route des Gorges, 38500, Voiron, France.
Int Orthop. 2021 Jul;45(7):1863-1869. doi: 10.1007/s00264-021-04993-8. Epub 2021 Feb 22.
The aims of this study were (1) to collect prospectively all tibial plateau fractures admitted to our department, over two ski seasons, and to classify them according to the Schatzker and AO classifications; (2) to assess if these classifications are accurate enough to include all types of fractures; and (3) to compare theses fractures with the series found in the literature, which included very few or no skiing accidents.
During the 2016-2017 and 2017-2018 ski seasons, we prospectively included 116 tibial plateau fractures caused by downhill skiing accidents. All patients underwent standard X-rays and 2D and 3D CT scans. The fractures were classified according to the AO and Schatzker revisited classifications.
The full series consisted of 56 males (48%) and 60 females (52%), aged 49 ± 16 years (18-77). There were 60 type B (52%) and 56 type C fractures (48%) for AO classification and 45.5% types I, II and III and 54.5% types IV, V and VI for Schatzker classification. Thirty-five frontal fractures (30%) were not differentiated under the AO classification and, likewise, associated tibial spine fractures (28.5%) were not differentiated in the Schatzker classification. We were also unable to classify anterior tibial tuberosity fractures (14.5%) and fibula head fractures (8%). The anatomo-pathological types were not so different from road traffic accidents.
Contrary to our hypothesis, the anatomical-pathological damage in tibial plateau fractures resulting from downhill skiing accidents was barely any different from those found in road traffic accidents. However, despite progress in classifications with the emergence of 3D CT scans, it is still not always possible to categorise all fractures within a given classification.
本研究的目的是：（1）在两个滑雪季中前瞻性地收集所有我院收治的胫骨平台骨折患者，并根据 Schatzker 和 AO 分类进行分类；（2）评估这些分类是否足够准确以包含所有类型的骨折；（3）与文献中发现的包含很少或没有滑雪事故的系列进行比较。
在 2016-2017 年和 2017-2018 年的滑雪季期间，我们前瞻性地纳入了 116 例因下坡滑雪事故导致的胫骨平台骨折患者。所有患者均接受标准 X 线和 2D 和 3D CT 扫描。骨折根据 AO 和修订后的 Schatzker 分类进行分类。
完整系列包括 56 名男性（48％）和 60 名女性（52％），年龄 49±16 岁（18-77 岁）。AO 分类中，60 型 B（52％）和 56 型 C（48％）骨折，Schatzker 分类中，45.5％的 I、II 和 III 型和 54.5％的 IV、V 和 VI 型骨折。35 例前侧骨折（30％）在 AO 分类中未区分，同样，Schatzker 分类中未区分胫骨结节骨折（28.5％）。我们也无法对胫骨前结节骨折（14.5％）和腓骨头骨折（8％）进行分类。解剖病理类型与道路交通伤没有太大区别。
与我们的假设相反，下坡滑雪事故导致的胫骨平台骨折的解剖-病理损伤与道路交通伤没有太大区别。然而，尽管随着 3D CT 扫描的出现，分类有了进步，但仍然不可能将所有骨折归类于特定分类中。
