• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

改良斜 Lobenneffer（MOL）入路治疗胫骨平台骨折后外侧柱和后内侧柱：详细的尸体解剖研究。

Modified Oblique Lobenhoffer (MOL) approach for posterolateral and posteromedial column access in tibial plateau fractures: a detailed cadaveric anatomical study.

机构信息

Orthopaedic Trauma Unit, Department of Orthopaedics, Hospital Universitario Canarias (HUC), Carretera Ofra S/N, 38320, La Laguna, Tenerife, Spain.

Department of Orthopaedics, Hospital Universitario Canarias (HUC), Carretera Ofra S/N, 38320, La Laguna, Tenerife, Spain.

出版信息

J Orthop Traumatol. 2024 May 20;25(1):27. doi: 10.1186/s10195-024-00769-z.

DOI:10.1186/s10195-024-00769-z
PMID:38769283
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11106229/
Abstract

BACKGROUND

Tibial plateau fractures involving posteromedial (PM) and posterolateral (PL) columns are complex injuries that require an appropriate approach. The management of the PL column in these cases can be controversial, and limitations using deep posteromedial interval approaches have been referenced. In this paper, a modification of the Lobenhoffer approach, designed to optimize the access to the PL column, is described in detail. The aim of this study was to assess the feasibility of this approach in a cadaveric anatomical study.

MATERIALS AND METHODS

In total, five fresh-frozen cadaveric specimens were used for detailed anatomical study surrounding the approach. Relationships with cutaneous and deep neurovascular structures were evaluated. The exposure area of the PL and PM columns using this approach was assessed.

RESULTS

The cadaveric study showed safe and adequate exposure. Oblique skin and fascia incision just medial to the posterior midline was safe to protect the medial sural cutaneous nerve and the small saphenous vein. Elevation of the popliteus and tibialis posterior muscles offered safe protection of the anterior tibial artery and popliteal neurovascular bundle during retractor placement. Adequate full proximal exposure of the PM and PL columns, including the posterolateral lateral (PLL) and posterolateral central (PLC) segments, was obtained in all specimens.

CONCLUSIONS

The Modified Oblique Lobenhoffer (MOL) approach can be a feasible option to access PL and PM columns in tibial plateau fractures.

LEVEL OF EVIDENCE

IV.

摘要

背景

涉及后内侧（PM）和后外侧（PL）柱的胫骨平台骨折是复杂的损伤，需要采用适当的方法进行治疗。在这些情况下，PL 柱的处理可能存在争议，并且已经提到了使用深部后内侧间隔入路的局限性。本文详细描述了一种改良的 Lobenhoffer 入路，旨在优化 PL 柱的入路。本研究的目的是在尸体解剖研究中评估这种方法的可行性。

材料和方法

共使用五个新鲜冷冻的尸体标本进行了详细的解剖学研究，以评估该入路周围的解剖结构。评估了与皮肤和深部神经血管结构的关系。评估了使用该入路暴露 PL 和 PM 柱的区域。

结果

尸体研究显示了安全且充分的暴露。在后正中线上内侧的斜行皮肤和筋膜切口可安全保护内侧腓肠皮神经和小隐静脉。在放置牵开器时，提起比目鱼肌和胫骨后肌可安全保护胫前动脉和腘血管神经束。在所有标本中均获得了 PM 和 PL 柱的充分近端暴露，包括后外侧外侧（PLL）和后外侧中央（PLC）段。

结论

改良的斜形 Lobenhoffer（MOL）入路可能是胫骨平台骨折中进入 PM 和 PL 柱的可行选择。

证据等级

IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/7ca44ffea72c/10195_2024_769_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/47041e0ea17a/10195_2024_769_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/e5b4f9ad2e14/10195_2024_769_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/2d2fa780ecb4/10195_2024_769_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/c133e6dba4e5/10195_2024_769_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/824e71efbe0f/10195_2024_769_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/a1fdca67fb18/10195_2024_769_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/dddcb3ddd140/10195_2024_769_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/2b914d3b2a89/10195_2024_769_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/83bd711282b8/10195_2024_769_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/ecf2081e4768/10195_2024_769_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/7ca44ffea72c/10195_2024_769_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/47041e0ea17a/10195_2024_769_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/e5b4f9ad2e14/10195_2024_769_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/2d2fa780ecb4/10195_2024_769_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/c133e6dba4e5/10195_2024_769_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/824e71efbe0f/10195_2024_769_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/a1fdca67fb18/10195_2024_769_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/dddcb3ddd140/10195_2024_769_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/2b914d3b2a89/10195_2024_769_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/83bd711282b8/10195_2024_769_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/ecf2081e4768/10195_2024_769_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77c/11106229/7ca44ffea72c/10195_2024_769_Fig11_HTML.jpg

相似文献

1
Modified Oblique Lobenhoffer (MOL) approach for posterolateral and posteromedial column access in tibial plateau fractures: a detailed cadaveric anatomical study.改良斜 Lobenneffer（MOL）入路治疗胫骨平台骨折后外侧柱和后内侧柱：详细的尸体解剖研究。
J Orthop Traumatol. 2024 May 20;25(1):27. doi: 10.1186/s10195-024-00769-z.
2
Posterolateral tibial plateau fractures, how to buttress? Reversed L posteromedial or the posterolateral approach: a comparative cadaveric study.胫骨平台后外侧骨折，如何进行支撑？后内侧反L形或后外侧入路：一项尸体对照研究。
Arch Orthop Trauma Surg. 2018 Apr;138(4):505-513. doi: 10.1007/s00402-018-2875-3. Epub 2018 Jan 19.
3
Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study.前外侧入路与改良后外侧入路治疗累及后柱的胫骨平台骨折：尸体研究。
Eur J Trauma Emerg Surg. 2023 Feb;49(1):201-207. doi: 10.1007/s00068-022-02113-8. Epub 2022 Sep 28.
4
Open Reduction and Internal Fixation of the Posteromedial Tibial Plateau via the Lobenhoffer Approach.经洛本霍费尔入路对胫骨平台后内侧进行切开复位内固定术。
J Orthop Trauma. 2016 Aug;30 Suppl 2:S35-6. doi: 10.1097/BOT.0000000000000582.
5
Surgical exposure to posterolateral quadrant tibial plateau fractures: an anatomic comparison of posterolateral and posteromedial approaches.手术入路显露胫骨平台后外侧象限骨折：后外侧入路与后内侧入路的解剖学比较。
J Orthop Surg Res. 2022 Jul 15;17(1):346. doi: 10.1186/s13018-022-03236-9.
6
[Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures].[治疗胫骨近端骨折的特定后内侧和后外侧入路]
Unfallchirurg. 1997 Dec;100(12):957-67. doi: 10.1007/s001130050218.
7
Newly designed plate for the treatment of posterolateral tibial plateau fractures: a finite element analysis.新型钢板治疗胫骨平台后外侧骨折的有限元分析。
J Orthop Surg Res. 2024 Mar 26;19(1):201. doi: 10.1186/s13018-024-04686-z.
8
[Osteotomy of non-core weight-bearing area of the lateral tibial plateau, reduction, and internal fixation in treatment of tibial plateau fractures involving posterolateral column collapse].[胫骨外侧平台非负重核心区截骨、复位及内固定治疗累及后外侧柱塌陷的胫骨平台骨折]
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Apr 15;37(4):410-416. doi: 10.7507/1002-1892.202301019.
9
Outcome of management of tibial plateau fracture by posterior Lobenhoffer approach: case series.后路 Lobenhoffer 入路治疗胫骨平台骨折的疗效：病例系列研究。
J Pak Med Assoc. 2023 May;73(5):1087-1090. doi: 10.47391/JPMA.1566.
10
A combined prone and supine approaches for complex three column tibial plateau fracture with posterolateral articular injury.采用俯卧位和仰卧位联合入路治疗合并后外侧关节面损伤的复杂三柱胫骨平台骨折。
Injury. 2019 Oct;50(10):1756-1763. doi: 10.1016/j.injury.2019.09.008. Epub 2019 Sep 6.

本文引用的文献

1
Biomechanical study of a new rim plate fixation strategy for two kinds of posterolateral depression patterns of tibial plateau fractures: a finite element analysis.生物力学研究：一种用于治疗胫骨平台骨折后外侧壁两种凹陷类型的新型边缘钢板固定策略：有限元分析。
J Orthop Surg Res. 2023 Nov 7;18(1):840. doi: 10.1186/s13018-023-04315-1.
2
Depression fractures of the posterolateral tibial plateau: Treatment by lateral femoral epicondyle osteotomy approach.胫骨平台后外侧凹陷性骨折：外侧股骨髁突切开术治疗。
Injury. 2023 Nov;54 Suppl 6:110620. doi: 10.1016/j.injury.2023.02.003. Epub 2023 Feb 8.
3
Influence of articular step-off on contact mechanics in fractures of the posterolateral-central tibial plateau - a biomechanical study.
关节台阶对胫骨平台后外侧-中央骨折接触力学的影响 - 一项生物力学研究。
Knee. 2023 Mar;41:283-291. doi: 10.1016/j.knee.2023.01.016. Epub 2023 Feb 11.
4
Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study.前外侧入路与改良后外侧入路治疗累及后柱的胫骨平台骨折：尸体研究。
Eur J Trauma Emerg Surg. 2023 Feb;49(1):201-207. doi: 10.1007/s00068-022-02113-8. Epub 2022 Sep 28.
5
A preliminary study of the surgical approach for posterior tibial plateau fractures: Based on posterior fragment segment classification.胫骨平台后骨折手术入路的初步研究：基于后骨折块节段分类。
Injury. 2022 Nov;53(11):3820-3827. doi: 10.1016/j.injury.2022.09.009. Epub 2022 Sep 12.
6
Medial Head of the Gastrocnemius Tenotomy Through a Posteromedial Approach Significantly Improves Surgical Accessibility of the Tibial Plateau.经后内侧入路行腓肠肌内侧头肌切断术可显著提高胫骨平台的手术可及性。
J Orthop Trauma. 2023 Jan 1;37(1):44-49. doi: 10.1097/BOT.0000000000002462.
7
Surgical exposure to posterolateral quadrant tibial plateau fractures: an anatomic comparison of posterolateral and posteromedial approaches.手术入路显露胫骨平台后外侧象限骨折：后外侧入路与后内侧入路的解剖学比较。
J Orthop Surg Res. 2022 Jul 15;17(1):346. doi: 10.1186/s13018-022-03236-9.
8
Supine Posterior Hoop Plating of Bicondylar Posterior Coronal Shear Tibial Plateau Fractures Without Fibular Osteotomy.双髁后冠状面剪切型胫骨平台骨折不进行腓骨截骨的仰卧位后环钢板固定术
J Orthop Trauma. 2023 Jan 1;37(1):e45-e50. doi: 10.1097/BOT.0000000000002420.
9
Revisiting the management of tibial plateau fractures.重新审视胫骨平台骨折的治疗。
Injury. 2022 Jun;53(6):2207-2218. doi: 10.1016/j.injury.2022.04.006. Epub 2022 Apr 28.
10
A proposal of a new algorithm for decision-making approaches in open reduction and internal fixation of complex tibial plateau fractures - SOTA algorithm (Spanish Orthopaedic Trauma Association).一种用于复杂胫骨平台骨折切开复位内固定术决策方法的新算法的提案 - SOTA 算法（西班牙矫形创伤协会）。
Injury. 2021 Jul;52 Suppl 4:S87-S98. doi: 10.1016/j.injury.2021.03.064. Epub 2021 May 1.