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经皮球囊治疗胫骨平台骨折:至少 5 年随访结果。

Percutaneous surgery with balloon for tibial plateau fractures, results with a minimum of 5 years of follow-up.

机构信息

CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France; Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, France.

CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France.

出版信息

Injury. 2022 Jul;53(7):2650-2656. doi: 10.1016/j.injury.2022.05.033. Epub 2022 May 20.

Abstract

Tibial plateau fracture is a frequent entity for which surgical management is difficult both surgically and postoperatively, with multiple complications and often delayed recovery. The challenge lies in the anatomical reduction of the joint, the limitation of complications and the rapid functional recovery. Tuberoplasty appears to be an innovative technique that meets current expectations. The objective is to evaluate the reliability of tuberoplasty in reducing surgical risks and improving postoperative clinical results. This single-centre retrospective study included 30 patients with depressed tibial plateau fractures who underwent tuberoplasty from September 2011 to March 2014. Reduction analysis was performed by comparing pre-operative and post-operative depression from computed tomography (CT) data. Clinical outcomes were assessed by measuring flexion joint ranges, time to weight-bearing, KOOS questionnaire and a pangonogram. The mean depression was 7.4mm pre-operatively and 2.6mm [0;9] post-operatively, with 47% (14/30) having a residual depression of 2mm or less. Mean flexion at 6 weeks was 103° [30; 130]. Partial and total weight-bearing were allowed on day 47 [3; 150] and day 58 [20; 150], respectively. The mean KOOS score was 25.43 [1.15; 62.30] at a minimum of 5 years after surgery and the mean axis was 176.54° [172; 180]. There was one case of thrombophlebitis and one sensory-motor deficit in the common fibular nerve territory. The reduction of the tibial plateau observed in our study from tuberoplasty is in line with the literature results obtained from a conventional approach. Our results indicate that tuberoplasty is stable in the long term, has good functional results and early recovery with few complications. This preliminary study presents results that need to be investigated in a prospective randomised double-blind study.

摘要

胫骨平台骨折是一种常见的疾病,其手术治疗具有挑战性,既包括手术方面,也包括术后方面,存在多种并发症,且往往恢复缓慢。挑战在于关节的解剖复位、并发症的限制以及快速的功能恢复。结节成形术似乎是一种创新性技术,能够满足当前的期望。目的是评估结节成形术在降低手术风险和改善术后临床结果方面的可靠性。这项单中心回顾性研究纳入了 2011 年 9 月至 2014 年 3 月期间接受结节成形术治疗的 30 例胫骨平台凹陷骨折患者。通过比较术前和术后 CT 数据来评估复位情况。通过测量膝关节屈曲活动度、负重时间、KOOS 问卷和正位片来评估临床结果。术前平均凹陷 7.4mm,术后平均 2.6mm[0;9],47%(14/30)患者残留凹陷 2mm 或以下。6 周时的平均屈曲度为 103°[30;130]。第 47 天[3;150]开始部分负重,第 58 天[20;150]开始完全负重。术后至少 5 年的平均 KOOS 评分为 25.43[1.15;62.30],平均轴向角为 176.54°[172;180]。有 1 例深静脉血栓形成和 1 例腓总神经感觉运动功能障碍。我们从结节成形术中观察到的胫骨平台复位与传统方法获得的文献结果一致。我们的结果表明,结节成形术长期稳定,功能结果良好,并发症少,恢复迅速。这项初步研究结果需要在一项前瞻性、随机、双盲研究中进一步验证。

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