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胫骨平台骨折内固定与外固定术后两年患者功能结局的比较研究

A Comparative Study on the Functional Outcomes of Patients who Underwent Internal versus External Fixation for Tibial Plateau Fractures Two Years Post-surgery.

作者信息

Feng Marianne Therese S, Akiatan-Rey Kristia Jimmylou, Deiparine Harem P, Pendang Rey P

机构信息

Vicente Sotto Memorial Medical Center.

出版信息

Acta Med Philipp. 2024 Jan 26;58(1):57-63. doi: 10.47895/amp.vi0.6181. eCollection 2024.

Abstract

INTRODUCTION

Tibial plateau fractures are due to high energy trauma brought about by axial compression forces and associated varus or valgus component.

OBJECTIVE

Patients diagnosed with tibial plateau fractures from January to December 2018 treated with internal vs external fixation will be described according to their Schatzker classification. The study further aims to compare the functional outcomes between the two groups in terms of surgery done.

METHODS

A chart review determined the distribution of demographics. The Modified Rasmussen Score (MRS) was used to determine the clinical and radiographic parameters after taking a new knee radiograph and assessment from the rehabilitation department. The MRS determined the functional outcomes of the said patients. Ethical considerations and proper informed consent were upheld after being reviewed by the hospital's research committee.

RESULTS

Out of 48 patients, 35 underwent internal fixation via open reduction using plates and/or screws, while 13 underwent external fixation using hybrid external fixator. The demographic profile showed mostly males between ages 20 to 49 years old. Most cases were due to vehicular accidents affecting the left lower extremity. In terms of Schatzker classification, the most common was type VI. The computed mean MRS of the internal fixation group was 30.43 while the external fixation group was 30.00, generally showing no significant difference.

CONCLUSION

Surgical intervention of tibial plateau fractures aims for anatomic reduction using internal or external fixation. There was no significant difference on the functional outcome of the two groups despite classifying the respondents according to Schatzker type, hence we can conclude that external fixation be chosen as the treatment of choice for tibial plateau fractures when properly indicated.

摘要

引言

胫骨平台骨折是由轴向压缩力以及相关的内翻或外翻成分所导致的高能量创伤引起的。

目的

描述2018年1月至12月诊断为胫骨平台骨折并接受内固定与外固定治疗的患者,依据其Schatzker分类进行阐述。该研究进一步旨在比较两组在手术方面的功能结局。

方法

通过图表回顾确定人口统计学分布。采用改良Rasmussen评分(MRS),在拍摄新的膝关节X线片并经康复科评估后,确定临床和影像学参数。MRS确定了上述患者的功能结局。经医院研究委员会审查后,秉持了伦理考量和适当的知情同意。

结果

48例患者中,35例通过切开复位使用钢板和/或螺钉进行内固定,13例使用混合外固定器进行外固定。人口统计学特征显示,大多数为20至49岁的男性。大多数病例是由影响左下肢的车辆事故导致的。在Schatzker分类方面,最常见的是VI型。内固定组的计算平均MRS为30.43,而外固定组为30.00,总体显示无显著差异。

结论

胫骨平台骨折的手术干预旨在通过内固定或外固定实现解剖复位。尽管根据Schatzker类型对受访者进行了分类,但两组的功能结局并无显著差异,因此我们可以得出结论,在有适当指征时,外固定可被选为胫骨平台骨折的首选治疗方法。

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本文引用的文献

1
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2
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Unfallchirurg. 2011 May;114(5):396-402. doi: 10.1007/s00113-011-1969-y.

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