Department of Orthopedics, General Hospital of Central Theater Command, 627 Wuluo Road, Wuchang District, Wuhan City, Hubei Province, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou City, Guangdong Province, China.
BMC Musculoskelet Disord. 2023 Aug 30;24(1):694. doi: 10.1186/s12891-023-06803-1.
The methods of reduction of depressed posterolateral fragments in tibial plateau fracture through anterolateral approaches remain controversial. This paper aimed to compare the intraarticular osteotomy technique and the "window" osteotomy technique for the reduction of depressed posterolateral fragments through anterolateral approach.
From January 2015 to January 2022, we retrospectively reviewed the data on patients with tibial plateau fracture involving depressed posterolateral fragments treated with the intraarticular osteotomy or the "window" osteotomy. 40 patients underwent the intraarticular osteotomy were divided into group A, while 36 patients underwent the "window" osteotomy were divided into group B. The operative time, bone grafting volume, fracture healing time, complication, reduction quality and postoperative functional results were compared between the two groups.
The average follow-up duration was 16.6 ± 3.7 months. The average bone grafting volume for all patients in group B was essential larger than group A (p = 0.001). Compared to group B, patients in groups A had significantly shorter fracture healing time (p = 0.011). The depth of depressed articular surface, PSA and the radiographic evaluation at 2 days and 6 months after surgery in group A were significantly lower than group B (p<0.05). Based on the HSS knee-rating score, no significant difference in function results was found between the two groups (p>0.05). No significant difference was found in operation time and blood loss between the two groups (p>0.05).
The intraarticular osteotomy could obtain satisfactory clinical results in tibial plateau fracture involving posterolateral fragments.
经前外侧入路复位胫骨平台骨折后塌陷的后外侧骨块的方法仍存在争议。本文旨在比较关节内截骨术和“窗口”截骨术治疗经前外侧入路后外侧骨块塌陷的疗效。
回顾性分析 2015 年 1 月至 2022 年 1 月采用关节内截骨术或“窗口”截骨术治疗胫骨平台骨折伴后外侧骨块塌陷的患者资料。40 例行关节内截骨术患者分为 A 组，36 例行“窗口”截骨术患者分为 B 组。比较两组患者的手术时间、植骨量、骨折愈合时间、并发症、复位质量和术后功能结果。
平均随访时间为 16.6±3.7 个月。B 组患者的平均植骨量明显大于 A 组（p=0.001）。与 B 组相比，A 组患者的骨折愈合时间明显缩短（p=0.011）。A 组患者术后 2 天和 6 个月的关节面凹陷深度、PSA 和影像学评估均明显低于 B 组（p<0.05）。基于 HSS 膝关节评分，两组患者的功能结果无显著差异（p>0.05）。两组患者的手术时间和出血量无显著差异（p>0.05）。
关节内截骨术治疗胫骨平台骨折后外侧骨块塌陷可获得满意的临床效果。
