Gausewitz S, Hohl M
Clin Orthop Relat Res. 1986 Jan(202):135-8.
Although the trend in management of tibial plateau fractures has been toward early motion, the period of immobilization that can be tolerated safely is open to question. In the present study, 160 acute tibial plateau fractures were reviewed in an effort to answer this question. The 112 fractures that were suitable for analysis were divided into undisplaced fractures, displaced fractures treated nonoperatively, and displaced fractures treated operatively. Among these groups, results were compared based on the period after injury that the knee was immobilized. Undisplaced fractures and displaced fractures that were treated nonoperatively regained full knee motion when immobilized up to six weeks. Fractures treated operatively tended to develop knee stiffness with only two weeks of immobilization. Loss of fracture reduction tended to occur in patients who were immobilized for relatively short periods. Immediate knee motion was correlated with prolonged hospitalization. Based on these results, knee mobilization following tibial plateau fractures is determined by the degree of fracture displacement, method of treatment, and quality of aftercare.
尽管胫骨平台骨折的治疗趋势已朝着早期活动发展，但安全耐受的固定期仍存在疑问。在本研究中，对160例急性胫骨平台骨折进行了回顾，以回答这个问题。适合分析的112例骨折被分为无移位骨折、非手术治疗的移位骨折和手术治疗的移位骨折。在这些组中，根据伤后膝关节固定的时间来比较结果。无移位骨折和非手术治疗的移位骨折在固定六周以内时可恢复全膝关节活动。手术治疗的骨折在仅固定两周时就容易出现膝关节僵硬。骨折复位丢失往往发生在固定时间相对较短的患者中。立即进行膝关节活动与住院时间延长相关。基于这些结果，胫骨平台骨折后的膝关节活动取决于骨折移位程度、治疗方法和术后护理质量。
