Hartwich Magdalena, Lans Jonathan, Jupiter Jesse B, Babst Reto, Regazzoni Petro, Dell'Oca Alberto Fernandez
Department of Traumatology, British Hospital, Avenida Italia 2420, 11600 Montevideo, Uruguay.
Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114, USA.
Injury. 2023 Mar 2. doi: 10.1016/j.injury.2023.02.050.
Tibial plateau fractures with significant joint depression and metaphyseal comminution pose a challenge. In order to prevent the collapse of the articular surface, some authors propose filling the subchondral void created during reduction with bone graft/substitute, which can add further complications. We present two cases of tibial plateau fractures with severe joint depression of the lateral condyle; both treated with a periarticular rafting construct, in one caseadditional bone substitute was used and in the other case no bone graft/substitute was used; their final outcomes were reported. The treatment of joint depression in tibial plateau fractures using periarticular rafting constructs without bone graft, may be also a valid option, to achieve good final results without the morbidity associated with the use of bone graft/substitutes.
伴有明显关节面塌陷和干骺端粉碎的胫骨平台骨折是一项挑战。为防止关节面塌陷，一些作者建议用骨移植材料/替代物填充复位过程中产生的软骨下骨缺损，这可能会增加更多并发症。我们报告两例外侧髁严重关节面塌陷的胫骨平台骨折病例；两例均采用关节周围漂浮结构治疗，其中一例使用了额外的骨替代物，另一例未使用骨移植材料/替代物；报告了它们的最终治疗结果。使用无骨移植的关节周围漂浮结构治疗胫骨平台骨折的关节面塌陷，可能也是一种有效的选择，可在不产生与使用骨移植材料/替代物相关的并发症的情况下获得良好的最终治疗效果。
