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在胫骨平台骨折治疗的分类中是否有必要增加软组织损伤这一因素?

Is It Necessary To Add Soft Tissue Injury to the Classification in Tibial Plateau Fracture Management?

作者信息

Tuncez Mahmut, Akan Ihsan, Seyfettinoğlu Fırat, Çetin Tunçez Hülya, Dirim Mete Berna, Kazımoğlu Cemal

机构信息

Department of Orthopedics and Traumatology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, TUR.

Department of Orthopedics and Traumatology, Adana City Training and Research Hospital, Adana, TUR.

出版信息

Cureus. 2022 Feb 15;14(2):e22236. doi: 10.7759/cureus.22236. eCollection 2022 Feb.

Abstract

Background A gold standard classification for the treatment of tibial plateau fractures with soft tissue injury has not been established yet.This study aimed to evaluate the usability of a novel modified classification that can provide preoperative information to the surgeon about soft tissue injuries in tibial plateau fractures. Methodology A total of 36 patients with tibial plateau fractures were included in the study. Patients' age, gender, and affected sides were recorded. Injuries to the medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament were examined with preoperative magnetic resonance imaging. Soft tissue injuries were arranged according to the novel modified classification based on the Schatzker classification. Results The mean age of the study participants was 45 (19-76) years; 72% of the patients were men and 28% were women. Moreover, 44% and 56% of the patients had broken the right and left tibial plateaus, respectively. At least one soft tissue injury was detected in 29 (81%) patients. In 14 (39%) patients, two or more soft tissue injuries were observed. All patients were arranged according to the novel modified classification regarding ligament and meniscus injuries. Conclusions With this novel modified classification system, we think that having better information about the preoperative condition of the soft tissue injuries can change the surgical strategy in patients with tibial plateau fractures.

摘要

背景 对于伴有软组织损伤的胫骨平台骨折,尚未建立金标准治疗分类。本研究旨在评估一种新型改良分类的实用性,该分类可为外科医生提供胫骨平台骨折软组织损伤的术前信息。方法 本研究共纳入36例胫骨平台骨折患者。记录患者的年龄、性别和患侧。术前通过磁共振成像检查内侧半月板、外侧半月板、前交叉韧带、后交叉韧带、内侧副韧带和外侧副韧带的损伤情况。软组织损伤根据基于Schatzker分类的新型改良分类进行整理。结果 研究参与者的平均年龄为45(19 - 76)岁;72%的患者为男性,28%为女性。此外,44%和56%的患者分别发生了右侧和左侧胫骨平台骨折。29(81%)例患者检测到至少一处软组织损伤。14(39%)例患者观察到两处或更多处软组织损伤。所有患者均根据韧带和半月板损伤的新型改良分类进行整理。结论 通过这种新型改良分类系统,我们认为更好地了解软组织损伤的术前情况可以改变胫骨平台骨折患者的手术策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c641/8929476/45fb3d26e4a4/cureus-0014-00000022236-i01.jpg

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