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使用干骺端套筒全膝关节置换术作为Schaztker VI型胫骨平台骨折的主要治疗方法。

The use of a metaphyseal sleeve total knee replacement as primary treatment for Schaztker VI tibial plateau fracture.

作者信息

McSorley Matthew, Jabbal Monu, Walmsley Phil

机构信息

Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.

出版信息

J Surg Case Rep. 2022 Dec 20;2022(12):rjac561. doi: 10.1093/jscr/rjac561. eCollection 2022 Dec.

DOI:10.1093/jscr/rjac561
PMID:36570549
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9769953/
Abstract

Traditional treatment of tibial plateau fractures is with open reduction and internal fixation, or external fixation in severely displaced and comminuted fractures. Total joint arthroplasty for unreconstructable hip fractures is a successful and widely accepted treatment; however, such surgery for tibial plateau fractures is not a common practice. We present two cases of highly comminuted schaztker VI tibial plateau fractures in patients over the age of 65. Both patients had a metaphyseal sleeve revision knee arthroplasty as delayed primary treatment. Both patients have had excellent clinical and radiographical results at 6 months and 5 years follow-up, respectively. We present the first description in the literature of this implants use for bone loss as a result of trauma. There is growing evidence that total joint arthroplasty is an effective treatment in tibial plateau fractures, in particular for elderly patients who may be at high risk of failure from internal fixation.

摘要

胫骨平台骨折的传统治疗方法是切开复位内固定，对于严重移位和粉碎性骨折则采用外固定。对于无法重建的髋部骨折，全关节置换术是一种成功且被广泛接受的治疗方法；然而，这种手术用于胫骨平台骨折并不常见。我们报告两例65岁以上患者的高度粉碎性Schaztker VI型胫骨平台骨折。两名患者均接受了经干骺端套筒翻修膝关节置换术作为延迟一期治疗。两名患者在分别随访6个月和5年时均取得了优异的临床和影像学结果。我们首次在文献中描述了这种植入物用于创伤导致的骨丢失。越来越多的证据表明，全关节置换术是治疗胫骨平台骨折的有效方法，特别是对于可能因内固定失败风险较高的老年患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/afa6943ac67c/rjac561f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/0c91cae49238/rjac561f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/ca66f8eaed80/rjac561f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/c5ea6f2830c7/rjac561f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/cb996d2e016d/rjac561f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/027ce65088cf/rjac561f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/5c1f23019450/rjac561f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/1cbe79ae7886/rjac561f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/afa6943ac67c/rjac561f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/0c91cae49238/rjac561f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/ca66f8eaed80/rjac561f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/c5ea6f2830c7/rjac561f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/cb996d2e016d/rjac561f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/027ce65088cf/rjac561f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/5c1f23019450/rjac561f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/1cbe79ae7886/rjac561f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/9769953/afa6943ac67c/rjac561f8.jpg

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本文引用的文献

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Cementless Metaphyseal Sleeve Fixation in Revision Knee Arthroplasty: Our Experience with an Arabic Population at the Midterm.膝关节置换翻修术中无骨水泥干骺端套筒固定：我们对阿拉伯人群的中期经验。
Adv Orthop. 2020 Sep 22;2020:5782853. doi: 10.1155/2020/5782853. eCollection 2020.
2
Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature.了解全膝关节置换术在胫骨平台骨折初次治疗中的作用：文献系统综述。
J Orthop Traumatol. 2020 May 25;21(1):7. doi: 10.1186/s10195-020-00546-8.
3
Metaphyseal Sleeves in Revision Total Knee Arthroplasty Provide Reliable Fixation and Excellent Medium to Long-Term Implant Survivorship.
翻修全膝关节置换术中的干骺端袖套提供可靠的固定和优异的中至长期假体生存率。
J Arthroplasty. 2020 Feb;35(2):495-499. doi: 10.1016/j.arth.2019.09.027. Epub 2019 Sep 21.
4
Comparison of Postoperative Outcomes Between Open Reduction and Internal Fixation and Ilizarov for Schatzker Type V and Type VI Fractures.切开复位内固定术与伊里扎洛夫技术治疗SchatzkerⅤ型和Ⅵ型骨折术后疗效比较
Cureus. 2019 Jun 14;11(6):e4902. doi: 10.7759/cureus.4902.
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Primary and Secondary Total Knee Arthroplasty for Tibial Plateau Fractures.胫骨平台骨折的初次和翻修全膝关节置换术。
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