Acta Orthop Belg. 2023 Mar;89(1):135-140. doi: 10.52628/89.1.9726.
Tibial plateau fractures are usually associated with soft tissue injury. This study aimed to use the extent of joint depression and lateral widening in computed tomography (CT) to predict the soft tissue injury accompanying fractures.The study included 23 patients with type Arbeitsgemeinschaft für Osteosynthesefragen-classified 41B fractures. Demographics, mechanism of injury, age, gender, and injury sites were assessed. Post-traumatic radiography, magnetic resonance imaging (MRI), and CT were obtained. MRI evaluated the meniscal, cruciate, and collateral ligament injuries, and CT measured the extent of joint depression and lateral widening in millimeters using digital imaging software. The relationship between joint depression, lateral widening, and soft tissue injuries was statistically analyzed. Of the 23 patients, 17 (74%) were males and 6 (26%) were females. Lateral meniscus injuries increased and the risk of bucket handle lateral meniscus tears increased as the CT joint depression exceeded 12 mm (p < 0.05). Joint depression of <5.9 mm was associated with medial meniscus injury (p < 0.05). The mean distribution examination of all soft tissue injuries and joint depression revealed no statistically significant difference between the groups (p > 0.05). Increased joint depression in lateral tibial plateau fractures increases the risk of lateral meniscus bucket handle tear, and decreased joint depression increases the risk of medial meniscus injury. Accordingly implementing the treatment plan and patient management will improve the clinical outcomes.
胫骨平台骨折通常伴有软组织损伤。本研究旨在通过 CT 测量关节凹陷和外侧增宽的程度来预测伴随骨折的软组织损伤。研究纳入了 23 例 Arbeitsgemeinschaft für Osteosynthesefragen 分类 41B 型骨折患者。评估了患者的人口统计学资料、损伤机制、年龄、性别和损伤部位。进行了创伤后 X 线摄影、磁共振成像(MRI)和 CT 检查。MRI 评估了半月板、交叉和侧副韧带损伤,CT 使用数字成像软件测量了关节凹陷和外侧增宽的程度(以毫米为单位)。使用统计学方法分析了关节凹陷、外侧增宽与软组织损伤之间的关系。23 例患者中,17 例(74%)为男性,6 例(26%)为女性。随着 CT 关节凹陷超过 12mm,外侧半月板损伤增加,桶柄状外侧半月板撕裂的风险增加(p<0.05)。关节凹陷<5.9mm 与内侧半月板损伤相关(p<0.05)。所有软组织损伤和关节凹陷的平均分布检查显示,组间无统计学差异(p>0.05)。外侧胫骨平台骨折关节凹陷增加会增加外侧半月板桶柄状撕裂的风险,关节凹陷减少会增加内侧半月板损伤的风险。因此,制定治疗计划和患者管理将改善临床结果。