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胫骨平台后外侧骨折:不同手术入路的利弊

Posterolateral tibia plateau fractures: pros and cons of different surgical approaches.

作者信息

Alessio-Mazzola Mattia, Placella Giacomo, Conca Marco, Salini Vincenzo

出版信息

EFORT Open Rev. 2025 Jun 2;10(6):416-423. doi: 10.1530/EOR-2025-0037.

Abstract

Posterolateral tibial plateau fractures are complex injuries requiring a thorough understanding of the anatomical structures involved, including the popliteus tendon, lateral collateral ligament and posterior horn of the lateral meniscus. Standard anterolateral or midline approaches provide limited access to the posterolateral corner, often necessitating specific surgical techniques to achieve optimal fracture reduction and joint stability. This review explores the main surgical approaches used for these fractures outlining their indications, advantages and limitations. Each section provides a step-by-step guide for an effective surgical technique, based on experience from a high-volume trauma center, to optimize exposure, reduction and fixation. Understanding the biomechanical and anatomical aspects of these fractures is crucial for selecting the most appropriate surgical strategy, minimizing complications and improving patient outcomes.

摘要

胫骨平台后外侧骨折是复杂的损伤,需要全面了解所涉及的解剖结构,包括腘肌腱、外侧副韧带和外侧半月板后角。标准的前外侧或中线入路对后外侧角的显露有限,常常需要特定的手术技术来实现最佳的骨折复位和关节稳定性。本综述探讨了用于这些骨折的主要手术入路,概述了其适应证、优点和局限性。每个部分都基于一个高容量创伤中心的经验,提供了有效手术技术的分步指南,以优化显露、复位和固定。了解这些骨折的生物力学和解剖学方面对于选择最合适的手术策略、减少并发症和改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1507/12139710/dcb9b023456c/EOR-2025-0037fig1.jpg

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