外侧胫骨平台骨折后，步态恢复与半月板和/或膝关节韧带损伤无关。一项前瞻性 3 年队列研究，共纳入 56 例患者。

Gait recovery is not associated with meniscus and/or knee ligament injuries following lateral tibial plateau fractures. A prospective 3-year cohort study of 56 patients.

机构信息

Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark; Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.

Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.

出版信息

Orthop Traumatol Surg Res. 2023 Sep;109(5):103569. doi: 10.1016/j.otsr.2023.103569. Epub 2023 Feb 2.

DOI:10.1016/j.otsr.2023.103569

PMID:36736456

Abstract

INTRODUCTION

Though associated meniscus and/or knee ligament injuries following lateral tibial plateau fractures (TPF) are common, the importance of development in gait recovery is unknown. This study aim to report the 12- and 36-month gait recovery in patients with lateral TPF divided into two groups presenting with and without associated meniscus and/or knee ligament injuries. (Associated meniscus and/or knee ligament injuries were grouped as: 1) missing, 2) lateral or medial menisci, 2) posterior and anterior cruciate ligament (PCL/ACL), and 4) lateral or medial collateral ligament.) HYPOTHESIS: Comparable results at the 12- and 36-month follow-up between groups presenting with and without soft tissue injuries.

PATIENTS AND METHODS

Study design: cohort study. Included were patients admitted following a lateral TPF (AO-type 41 B) between December 1, 2013 and November 30, 2016. The primary outcome score was gait sample.

RESULTS

Fifty-six patients were included. The mean age of the patients at the time of fracture was 56 years (range from 22 to 86). Female gender represents 75%. MRI-verified associated meniscus and/or knee ligament injuries were observed in 28 patients (50%). The average gait speed at the 12- and 36-month follow-up were 125.7 (SD31.3) and 127.7 (SD16.6) cm/sec. for patients with associated meniscus and/or knee ligament injuries and 125.2 (SD31.1) and 130.1 (SD15.6) cm/sec. for patients without associated meniscus and/or knee ligament injuries (p=0.96, p=0.17). Regardless of soft tissue injuries, the development in percent of gait asymmetry for step-length and single-support decrease significantly between the 12- and the 36-month follow-up. (p>0.002) DISCUSSION: This study indicates that gait recovery following lateral TPFs were not associated with associated meniscus and/or knee ligament injuries at the 12- and 36-month follow-up. Between the 12- and 36-month follow-up asymmetry of the gait function decline significantly indicating a prolonged recovery period of gait function following TPFs.

LEVEL OF EVIDENCE

II; prospective cohort study.

摘要

简介

尽管外侧胫骨平台骨折（TPF）后常伴有半月板和/或膝关节韧带损伤，但这些损伤对步态恢复的重要性尚不清楚。本研究旨在报告外侧 TPF 患者在分为伴有和不伴有半月板和/或膝关节韧带损伤两组后的 12 个月和 36 个月的步态恢复情况。（半月板和/或膝关节韧带损伤分为：1）缺失，2）外侧或内侧半月板，2）后交叉韧带和前交叉韧带（PCL/ACL），4）外侧或内侧副韧带。）假设：伴有和不伴有软组织损伤的两组在 12 个月和 36 个月的随访中结果相似。

患者和方法

研究设计：队列研究。纳入 2013 年 12 月 1 日至 2016 年 11 月 30 日期间因外侧 TPF（AO 型 41 B）住院的患者。主要结局评分是步态样本。

结果

共纳入 56 例患者。骨折时患者的平均年龄为 56 岁（范围 22-86 岁）。女性占 75%。28 例患者（50%）MRI 证实伴有半月板和/或膝关节韧带损伤。伴有半月板和/或膝关节韧带损伤的患者在 12 个月和 36 个月随访时的平均步态速度分别为 125.7（SD31.3）和 127.7（SD16.6）cm/sec。无半月板和/或膝关节韧带损伤的患者分别为 125.2（SD31.1）和 130.1（SD15.6）cm/sec。（p=0.96，p=0.17）。无论是否存在软组织损伤，在 12 个月和 36 个月随访时，步长和单足支撑的步态不对称百分比的发展均显著下降。（p>0.002）。讨论：本研究表明，外侧 TPF 后的步态恢复与 12 个月和 36 个月随访时的半月板和/或膝关节韧带损伤无关。在 12 个月至 36 个月的随访中，步态功能的不对称性显著下降，表明 TPF 后步态功能的恢复时间延长。