Zhang Jia-Fan, Long An-Hua, Han Da-Cheng, Jia Zi-Chao, Zhang Ya-Kui
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
Emergency General Hospital, Beijing 100020, China.
Zhongguo Gu Shang. 2025 Jan 25;38(1):100-4. doi: 10.12200/j.issn.1003-0034.20240268.
Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia. In the natural state, the posterior tibial slope(PTS) is altered to involve the soft tissues around the knee joint such as anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL), which affects the stability of the knee joint. In total knee arthroplasty(TKA), choosing the appropriate PTS can effectively increase the prosthesis survival rate, improve the flexion and extension knee efficacy, which is beneficial to knee joint stability. In the field of orthopedic trauma, correction of sagittal deformity is equally important, following the principle of "reverse mechanism of injury". Quantitative evaluation of postoperative sagittal realignment of tibial plateau fractures and investigation of the effect of sagittal realignment on long-term outcomes and complications are still poorly understood and require further clinical and biomechanical studies.
胫骨平台骨折是累及胫骨近端关节面的骨折，其损伤机制复杂，骨折形态各异，常伴有不同程度的软组织损伤，诊断和治疗困难。近年来，研究热点集中在解决胫骨平台后外侧柱的复位与固定问题，因为临床发现胫骨平台骨折后矢状面复位不足或复位丢失会导致膝关节功能障碍。胫骨平台后倾角是描述胫骨矢状位对线的重要参数。在自然状态下，胫骨后倾角（PTS）改变会累及膝关节周围软组织，如前交叉韧带（ACL）和后交叉韧带（PCL），影响膝关节稳定性。在全膝关节置换术（TKA）中，选择合适的PTS可有效提高假体生存率，改善膝关节屈伸功能，有利于膝关节稳定。在创伤骨科领域，遵循“损伤机制逆向”原则，纠正矢状面畸形同样重要。目前对胫骨平台骨折术后矢状位对线的定量评估以及矢状位对线对长期疗效和并发症影响的研究仍较少，需要进一步的临床和生物力学研究。
