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胫骨平台骨折后内侧骨折块的临床及影像学意义

Clinical and radiological significance of posteromedial fragment in tibial plateau fractures.

作者信息

Akdemir Mehmet, Türken Mehmet Aykut, Turan Ahmet Cemil, Biçen Ahmet Çağdaş, Kılıç Ali İhsan

机构信息

Department of Orthopedics and Traumatology, Ekol Hospital, Izmir, Turkey.

Department of Orthopedics and Traumatology, Medikal Park Izmir Hospital, Izmir, Turkey.

出版信息

J Orthop. 2022 Apr 25;31:110-116. doi: 10.1016/j.jor.2022.04.012. eCollection 2022 May-Jun.

Abstract

INTRODUCTION

The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results.

PATIENTS AND METHODS

Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically.

RESULTS

38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05).

CONCLUSIONS

The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.

摘要

引言

近年来,关节碎片,尤其是后内侧碎片,对胫骨平台骨折治疗结果的影响已得到更好的理解。在本研究中,我们想探讨伴随的后内侧碎片是否对临床和影像学结果有影响。

患者与方法

对因胫骨平台骨折接受切开复位钢板螺钉内固定治疗的患者进行回顾性筛查。将患者分为有后内侧碎片组和无后内侧碎片组。对临床、影像学和并发症进行统计学比较。

结果

52例患者中有38例纳入研究。患者平均年龄为46.08岁,女性26例(68.42%),男性12例(31.58%)。平均随访18.55个月。21例(55.6%)患者有后内侧碎片,17例(44.4%)患者无后内侧碎片。根据拉斯穆森临床和影像学标准对两组进行比较时,未发现统计学上的显著差异。两组在感染、骨不连、畸形愈合、关节分离、早期关节炎和关节纤维性变的发生率方面无统计学显著差异(p>0.05)。两组在复位丢失率方面存在统计学显著差异(p<0.05)。

结论

伴有后内侧碎片的胫骨平台骨折是特征性骨折。应注意维持骨折固定的稳定性。

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A review of the management of tibial plateau fractures.胫骨平台骨折的治疗综述。
Musculoskelet Surg. 2018 Aug;102(2):119-127. doi: 10.1007/s12306-017-0514-8. Epub 2017 Oct 17.

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