Albishi Waleed, Alsharidah Abdulrahman M, Alkhuraiji Abdullah, Dalati Zaheer, Alsanawi Hisham
Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, SAU.
Orthopedic Surgery, King Saud University Medical City, Riyadh, SAU.
Cureus. 2021 Jun 22;13(6):e15834. doi: 10.7759/cureus.15834. eCollection 2021 Jun.
Tibial plateau fractures are quite common among lower limb fractures Several fracture classifications exist including Schatzker classification, in which tibial plateau fractures are divided into six types where each increasing numerical category indicates increasing severity of the injury and worsening prognosis. Arthroscopic-assisted techniques using a lateral or medial metaphyseal window have shown results comparable to open internal fixation methods with multiple advantages. We present a case of a medically and surgically free 40-year-old lady who presented to our emergency department complaining of left knee pain following a fall from the stairs. Clinically there was significant swelling and tenderness over the lateral aspect of the left proximal tibia, radiographs showed a Schatzker type III tibial plateau fracture, confirmed by computed tomography (CT). A combined intraoperative arthroscopic- and fluoroscopic-guided reduction of the articular depression through a lateral cortical window was achieved and the fracture was fixed using a minimally invasive fixation technique. The postoperative course was uneventful. The patient had recovered full range of motion and the wounds were barely visible. One-year X-ray showed healed fracture without any evidence of displacement or subsidence.
胫骨平台骨折在下肢骨折中颇为常见。存在多种骨折分类方法，包括施查茨克分类法，其中胫骨平台骨折被分为六种类型，数字类别越高表明损伤越严重，预后越差。使用外侧或内侧干骺端窗口的关节镜辅助技术已显示出与切开内固定方法相当的效果，且具有多种优势。我们报告一例40岁健康女性病例，她因从楼梯上摔倒后出现左膝疼痛前来我院急诊科就诊。临床上，左胫骨近端外侧有明显肿胀和压痛，X线片显示为施查茨克III型胫骨平台骨折，计算机断层扫描（CT）予以证实。通过外侧皮质窗口在术中联合关节镜和透视引导下对关节凹陷进行复位，并采用微创固定技术固定骨折。术后过程顺利。患者恢复了全关节活动范围，伤口几乎不可见。一年后的X线显示骨折愈合，无任何移位或塌陷迹象。
