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胫骨平台骨折合并腓骨柱损伤的分类与治疗策略。

Classification and Treatment Strategies of Concomitant Fibular Column Injuries in Tibial Plateau Fractures.

机构信息

Department of Orthopaedics, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu Province 212000, China.

Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China.

出版信息

Biomed Res Int. 2021 Sep 6;2021:2698642. doi: 10.1155/2021/2698642. eCollection 2021.

DOI:10.1155/2021/2698642
PMID:34532498
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8440093/
Abstract

BACKGROUND

About 1/3 of tibial plateau fractures are associated with proximal fibula fractures, but most proximal fibula fractures are often ignored. The aim of this study was to precisely explain the classification and treatment strategies of six injury types of the fibular column associated with tibial plateau fractures.

METHODS

Patients with ipsilateral proximal fibula and tibial plateau fractures treated in our hospital were retrospectively reviewed from Aug 2007 to Mar 2020. Two experienced surgeons and two radiologists divided fibular column injury into 6 injury types according to the AO classification and four-column nine-segment classification. The treatment scheme (surgically treated or conservatively treated) was also recorded.

RESULTS

In total, 355 proximal fibula fractures were included. Type 2 fibular head fracture was the most common type of injury in 122, and the segregate of superior tibiofibular syndesmosis was the rarest type in 3. In avulsion injury proximal of fibular pattern, the proportion of patients who need surgical intervention is the highest.

CONCLUSIONS

Six injury types in the four-column nine-segment classification covered all types of bony and soft tissue injuries of the fibular column and concisely explained the injury mechanism. The classification is helpful for the precise judgement and decision-making of the concomitant fibular column injuries in tibial plateau fractures.

摘要

背景

约 1/3 的胫骨平台骨折与腓骨近端骨折相关，但大多数腓骨近端骨折常被忽视。本研究旨在精确阐述与胫骨平台骨折相关的腓骨柱 6 种损伤类型的分类和治疗策略。

方法

回顾性分析 2007 年 8 月至 2020 年 3 月我院收治的同侧腓骨近端和胫骨平台骨折患者。2 名经验丰富的外科医生和 2 名放射科医生根据 AO 分类和四柱九段分类将腓骨柱损伤分为 6 种损伤类型。还记录了治疗方案（手术治疗或保守治疗）。

结果

共纳入 355 例腓骨近端骨折。2 型腓骨头骨折最常见，共 122 例，3 例为分隔的胫腓联合上部分离。在腓骨模式近端的撕脱伤中，需要手术干预的患者比例最高。

结论

四柱九段分类中的 6 种损伤类型涵盖了腓骨柱所有类型的骨和软组织损伤，并简明地阐述了损伤机制。该分类有助于精确判断和决策胫骨平台骨折合并腓骨柱损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/ad02d3cec1b6/BMRI2021-2698642.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/4bef423b043d/BMRI2021-2698642.001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/a6eef8b2826f/BMRI2021-2698642.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/1d9b044bdefa/BMRI2021-2698642.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/3ed8012cf5dc/BMRI2021-2698642.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/ad02d3cec1b6/BMRI2021-2698642.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/4bef423b043d/BMRI2021-2698642.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/68186375ac6a/BMRI2021-2698642.003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/7804bbfbf988/BMRI2021-2698642.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/a6eef8b2826f/BMRI2021-2698642.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/1d9b044bdefa/BMRI2021-2698642.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/3ed8012cf5dc/BMRI2021-2698642.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/8440093/ad02d3cec1b6/BMRI2021-2698642.009.jpg

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