Suppr超能文献

骨质疏松性胫骨近端骨折

Proximal Tibia Fractures in Osteoporosis.

作者信息

Sauhta Ravi, Makkar Dheeraj

机构信息

Artemis Hospital Gurgaon, Gurgaon, Haryana India.

University of Iowa Hospital and Clinics, Iowa City, Iowa USA.

出版信息

Indian J Orthop. 2025 Feb 16;59(3):326-345. doi: 10.1007/s43465-025-01337-1. eCollection 2025 Mar.

Abstract

BACKGROUND

Tibial plateau fractures are frequently observed in elderly patients, often resulting from low-energy trauma. The treatment of tibial plateau fractures in this population is further complicated by factors such as osteoporosis, osteoarthritis, and other medical comorbidities.

OBJECTIVE

This article provides a comprehensive review of the different treatment strategies for proximal tibial fractures in the elderly. A variety of internal and external fixation techniques, medical management as well as acute arthroplasty, are discussed as potential approaches for achieving optimal reconstruction and functional recovery.

WHAT IS ALREADY KNOWN

Existing literature emphasizes that osteoporotic bones, characterized by reduced bone density and compromised structural integrity, pose significant challenges to fracture fixation. These factors often diminish the efficacy of fixation devices in proximal tibial fractures, leading to an increased likelihood of fixation failure.

GAP IN LITERATURE

While the high failure rates associated with osteoporotic bone fixation are wellrecognized, there is a notable lack of comprehensive studies that integrate biomechanical, biological, and technological advancements to improve fixation outcomes, in proximal tibial fractures. This article aims to address this gap by reviewing current diagnostic approaches and exploring innovative strategies involving advanced materials and regenerative technologies designed to enhance fixation success.

CONCLUSION

The management of proximal tibial fractures in the elderly requires a nuanced approach that integrates surgical intervention with medical management. A tailored treatment plan, based on specific fracture characteristics and overall health, is critical to optimizing postoperative functional outcomes. This article emphasizes the importance of a comprehensive, individualized treatment strategy to improve recovery and quality of life for elderly patients suffering from tibial plateau fractures.

摘要

背景

胫骨平台骨折在老年患者中较为常见,通常由低能量创伤引起。骨质疏松、骨关节炎和其他合并症等因素使该人群胫骨平台骨折的治疗更加复杂。

目的

本文全面综述了老年患者胫骨近端骨折的不同治疗策略。讨论了各种内固定和外固定技术、药物治疗以及急性关节置换术,作为实现最佳重建和功能恢复的潜在方法。

已知信息

现有文献强调,骨质疏松性骨以骨密度降低和结构完整性受损为特征,给骨折固定带来重大挑战。这些因素常常降低胫骨近端骨折固定装置的疗效,导致固定失败的可能性增加。

文献空白

虽然与骨质疏松性骨固定相关的高失败率已得到充分认识,但显著缺乏综合研究,这些研究整合生物力学、生物学和技术进步以改善胫骨近端骨折的固定效果。本文旨在通过综述当前诊断方法并探索涉及先进材料和再生技术的创新策略来填补这一空白,这些策略旨在提高固定成功率。

结论

老年患者胫骨近端骨折的治疗需要一种细致入微的方法,将手术干预与药物治疗相结合。基于特定骨折特征和整体健康状况制定的个性化治疗方案对于优化术后功能结果至关重要。本文强调全面、个性化治疗策略对于改善胫骨平台骨折老年患者的恢复情况和生活质量的重要性。

相似文献

1
Proximal Tibia Fractures in Osteoporosis.
Indian J Orthop. 2025 Feb 16;59(3):326-345. doi: 10.1007/s43465-025-01337-1. eCollection 2025 Mar.
2
Fixation Failure in Osteoporotic Bone: A Review of Complications and Outcomes.
Indian J Orthop. 2024 Dec 21;59(3):389-404. doi: 10.1007/s43465-024-01316-y. eCollection 2025 Mar.
3
The "umbrella" technique: reducing hoop stress during suprapatellar nailing in complex proximal tibial fractures.
Eur J Orthop Surg Traumatol. 2025 Feb 5;35(1):61. doi: 10.1007/s00590-025-04180-0.
4
5
Interventions for treating proximal humeral fractures in adults.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD000434. doi: 10.1002/14651858.CD000434.pub3.
6
Surgical fixation methods for tibial plateau fractures.
Cochrane Database Syst Rev. 2024 Aug 22;8(8):CD009679. doi: 10.1002/14651858.CD009679.pub3.
7
What Factors Are Associated With Implant Revision in the Treatment of Pathologic Subtrochanteric Femur Fractures?
Clin Orthop Relat Res. 2025 Mar 1;483(3):473-484. doi: 10.1097/CORR.0000000000003291. Epub 2024 Oct 22.
8
Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis.
Cochrane Database Syst Rev. 2022 Feb 10;2(2):CD013405. doi: 10.1002/14651858.CD013405.pub2.
9
Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis.
Cochrane Database Syst Rev. 2022 Feb 14;2(2):CD013404. doi: 10.1002/14651858.CD013404.pub2.
10
[Ipsilateral femoral neck fracture after fixation of intertrochanteric fracture by InterTAN intramedullary nail: A case report].
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Jun 18;57(3):610-613. doi: 10.19723/j.issn.1671-167X.2025.03.028.

本文引用的文献

2
Locked Plating and Advanced Augmentation Techniques in Osteoporotic Fractures.
Orthop Clin North Am. 2019 Apr;50(2):159-169. doi: 10.1016/j.ocl.2018.12.002. Epub 2019 Feb 12.
3
Internal Fixation of Osteoporotic Bone.
J Am Acad Orthop Surg. 2018 Mar 1;26(5):166-174. doi: 10.5435/JAAOS-D-16-00142.
4
Surgical treatment of osteoporotic fractures: An update on the principles of management.
Injury. 2017 Dec;48 Suppl 7:S34-S40. doi: 10.1016/j.injury.2017.08.036. Epub 2017 Sep 4.
5
Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification".
Injury. 2016 Nov;47(11):2551-2557. doi: 10.1016/j.injury.2016.09.014. Epub 2016 Sep 6.
6
Tibial Plateau Fractures in Elderly Patients.
Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):126-34. doi: 10.1177/2151458516651310. Epub 2016 Jun 6.
7
Open Reduction and Internal Fixation of the Posteromedial Tibial Plateau via the Lobenhoffer Approach.
J Orthop Trauma. 2016 Aug;30 Suppl 2:S35-6. doi: 10.1097/BOT.0000000000000582.
8
Failure of fracture fixation in osteoporotic bone.
Injury. 2016 Jun;47 Suppl 2:S3-S10. doi: 10.1016/S0020-1383(16)47002-6.
9
Population-Based Epidemiology of Tibial Plateau Fractures.
Orthopedics. 2015 Sep;38(9):e780-6. doi: 10.3928/01477447-20150902-55.
10
Total knee replacement in acute and chronic traumatic events.
Injury. 2014 Dec;45 Suppl 6:S98-S104. doi: 10.1016/j.injury.2014.10.031. Epub 2014 Oct 28.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验