Jiang Wei, Liu Xu, Kong Xiang-Ru, Wang Bing, Sun Jian-Ning, Zheng Hong-Bin, Chen Ming
Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China.
Department of Orthopedics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.
BMC Surg. 2025 Jan 13;25(1):22. doi: 10.1186/s12893-024-02756-x.
To explore the advantages of a lateral tibial locking plate combined with Jail screw fixation in the treatment of anterolateral tibial plateau collapse fracture (ATPCF).
A retrospective analysis was conducted on patients with ATPCFs admitted to our hospital from February 2019 to February 2023. Twenty-six patients were successfully included, including 15 males and 11 females, with an average age of 58.6 ± 7.8 years (range 45-68 years). All fractures were Schatzker type II fractures. After fracture reduction and fixation, a lateral locking titanium plate was placed through the anterolateral approach of the tibial plateau, and two screws of appropriate length were placed in the sagittal direction according to the Jail screw technique. Postoperative evaluation indices included surgery time, fracture healing time, the degree of tibial plateau collapse shown by computed tomography (CT) images at 3 days and 1 year after surgery, and the patient's knee range of motion at 1 year after surgery. The effects of fracture reduction and fixation before surgery, 3 days after surgery and 1 year after surgery were evaluated by the Rasmussen radiological score. The Hospital for Special Surgery (HSS) knee score was used to evaluate the knee joint function of patients at 1 year after surgery.
The average operation time was 64 ± 6.8 min (range 56-82 min). The fractures healed clinically at 13.8 ± 2.8 weeks (range 12-18 weeks) postoperation. After 15 ± 3.1 months (range 12-19 months) of average follow-up, all the patients were pain-free with a full range of motion and stable knees. At the 1-year postoperative assessment, the CT images showed no secondary collapse of the articular surface, the average knee range of motion was 136.3 ± 2.5° (range, -5° to 135°), the average Rasmussen radiological score was 16.2 ± 0.8 points, and the average HSS knee score was 93.6 ± 3.2 points.
The fixation of a anterolateral tibial plateau collapse fracture(ATPCF) using a lateral locking plate and the Jail screw technique has achieved good knee joint function, providing a new option for the treatment of ATPCFs. The clinical efficacy is satisfactory in the short term, avoiding secondary articular surface collapse.
探讨外侧胫骨锁定钢板联合Jail螺钉固定治疗胫骨前外侧平台塌陷骨折（ATPCF）的优势。
对2019年2月至2023年2月我院收治的ATPCF患者进行回顾性分析。成功纳入26例患者，其中男性15例，女性11例，平均年龄58.6±7.8岁（范围45 - 68岁）。所有骨折均为Schatzker II型骨折。骨折复位固定后，经胫骨平台前外侧入路置入外侧锁定钛板，并根据Jail螺钉技术在矢状面置入两枚合适长度的螺钉。术后评估指标包括手术时间、骨折愈合时间、术后3天及1年时计算机断层扫描（CT）图像显示的胫骨平台塌陷程度，以及术后1年时患者膝关节活动范围。采用Rasmussen放射学评分评估术前、术后3天及术后1年骨折复位固定效果。采用美国特种外科医院（HSS）膝关节评分评估术后1年患者膝关节功能。
平均手术时间为64±6.8分钟（范围56 - 82分钟）。术后13.8±2.8周（范围12 - 18周）临床骨折愈合。平均随访15±3.1个月（范围12 - 19个月）后，所有患者均无疼痛，膝关节活动范围正常且稳定。术后1年评估时，CT图像显示关节面无二次塌陷，平均膝关节活动范围为136.3±2.5°（范围，-5°至135°），平均Rasmussen放射学评分为16.2±0.8分，平均HSS膝关节评分为93.6±3.2分。
采用外侧锁定钢板和Jail螺钉技术固定胫骨前外侧平台塌陷骨折（ATPCF）取得了良好的膝关节功能，为ATPCF的治疗提供了新的选择。短期内临床疗效满意，避免了关节面二次塌陷。
