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膝下截肢患者的双髁胫骨平台骨折:一例罕见损伤病例报告

Bicondylar Tibial Plateau Fracture in Below-Knee Amputation: A Rare Injury Case Report.

作者信息

Helmstetter Timothée, Cannière Alexandre De, Jaen Matthieu, Vacariu Edina

机构信息

Department of Orthopaedic Surgery, Hôpital Pourtalès, Rue de la Maladière, Neuchâtel, Switzerland.

出版信息

J Orthop Case Rep. 2024 Oct;14(10):79-83. doi: 10.13107/jocr.2024.v14.i10.4818.

Abstract

INTRODUCTION

With current prostheses, below-knee amputees have sufficient mobility to perform activities with a risk of trauma and therefore fracture. However, bicondylar fractures of the tibial plateau are rare in this population and we found no recent literature or consensus regarding the management of these fractures. The aim of this study is to report a case with its surgical management, post-operative follow-up, and the specificities inherent in transtibial amputees.

CASE REPORT

This is a case of 33-year-old below-the-knee amputee male who sustained an ipsilateral tibial plateau fracture after an electric scooter accident. The patient underwent open reduction and internal fixation with posteromedial and anterolateral plate using dual incision. We followed the patient for 1 year with good clinical and functional outcomes.

CONCLUSION

Bicondylar fractures of the proximal tibia in below-knee amputees are rare injuries with potentially severe consequences. Nevertheless, appropriate surgical management and multidisciplinary collaboration with physiotherapists and orthopedic technicians allow the patient to regain mobility and autonomy without compromising prosthesis fitting in the long term.

摘要

引言

使用当前的假肢,膝下截肢者具备足够的活动能力来进行有创伤风险甚至因此有骨折风险的活动。然而,胫骨平台双髁骨折在该人群中较为罕见,并且我们未发现近期有关这些骨折治疗的文献或共识。本研究的目的是报告一例病例及其手术治疗、术后随访情况,以及经胫骨截肢者所特有的情况。

病例报告

这是一名33岁的膝下截肢男性患者,在一次电动滑板车事故后发生同侧胫骨平台骨折。患者接受了双切口切开复位,使用后内侧和前外侧钢板进行内固定。我们对患者进行了1年的随访,临床和功能结果良好。

结论

膝下截肢者的胫骨近端双髁骨折是罕见损伤,可能会产生严重后果。尽管如此,适当的手术治疗以及与物理治疗师和矫形技师的多学科协作,能使患者恢复活动能力和自主性,且不会在长期影响假肢适配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cce4/11458237/ffc7732c5cfa/JOCR-14-79-g001.jpg

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