Division of Orthopedics, Sunnybrook Health Sciences Center, University of Toronto, Ontario, Canada.
Department of Orthopedics, University of Missouri, Columbia, MO, United States.
Injury. 2022 Jun;53(6):2207-2218. doi: 10.1016/j.injury.2022.04.006. Epub 2022 Apr 28.
Three-dimensional imaging has changed the understanding and management of tibial plateau fractures. In the 1970s, Schatzker proposed a classification for tibial plateau fractures, which highlighted the morphology of the six principal types. More recently, this original classification was complimented by an extended one underscoring the importance of understanding where the split wedge fragment(s) is/are located in three dimensions. The extended classification introduced the split wedge fragment and the continuity of the rim as the determinants of joint stability and the critical role that this plays in the management of tibial plateau fractures. The current manuscript re-emphasizes contemporary concepts of tibial plateau stability and depicts key issues which must be considered when planning the definitive surgical fixation of tibial plateau fractures.
三维成像改变了人们对胫骨平台骨折的理解和处理方式。20 世纪 70 年代,Schatzker 提出了胫骨平台骨折的分类,突出了六种主要类型的形态。最近,这种原始分类得到了扩展分类的补充,强调了理解楔形骨折块在三维空间中的位置的重要性。扩展分类引入了楔形骨折块和边缘的连续性作为关节稳定性的决定因素,以及这在胫骨平台骨折治疗中所起的关键作用。本文重新强调了胫骨平台稳定性的现代概念,并描述了在计划胫骨平台骨折的确定性手术固定时必须考虑的关键问题。