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对于累及后外侧柱的II型胫骨平台骨折,采用扩大前外侧入路与Frosch入路的回顾性病例系列研究。

Extended anterolateral versus Frosch approach for type II tibial plateau fractures involving the posterolateral column: A retrospective case series study.

作者信息

Zhang Jiakai, Zheng Yi, Wu Junlong, Yuan Xinhua

机构信息

Department of Orthopedics, Ningbo No.2 Hospital, Ningbo, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2025 Jun 20;104(25):e42767. doi: 10.1097/MD.0000000000042767.

DOI:10.1097/MD.0000000000042767
PMID:40550075
Abstract

This study aimed to compare the extended anterolateral approach and the Frosch approach for treating type II tibial plateau fractures (based on the Schatzker classification system) involving the posterolateral column. A retrospective study was undertaken to compare general patient characteristics, intraoperative and postoperative outcomes, the Hospital for Special Surgery score, Rasmussen radiology score, tibial plateau angle, and posterior slope angle immediately after surgery and at a 1-year follow-up, between the 2 surgical approaches utilized between 2016 and 2020. Fifty-two patients with Schatzker type II fractures from Ningbo No. 2 Hospital were enrolled. No significant demographic differences existed between the 2 surgical groups. The Frosch approach group had slightly longer operative times but better hospital for special surgery knee scores and Rasmussen radiology scores than the extended anterolateral approach group. Both approaches achieved good outcomes for simple posterolateral fractures. For complex fractures, the Frosch approach may enabled more accurate reduction and superior biomechanical stability.

摘要

本研究旨在比较扩大前外侧入路与Frosch入路治疗涉及后外侧柱的Ⅱ型胫骨平台骨折(基于Schatzker分类系统)的效果。进行了一项回顾性研究,比较2016年至2020年间采用的两种手术入路在一般患者特征、术中和术后结果、特种外科医院评分、Rasmussen放射学评分、术后即刻及1年随访时的胫骨平台角和后倾角方面的差异。纳入了来自宁波市第二医院的52例SchatzkerⅡ型骨折患者。两个手术组之间在人口统计学方面无显著差异。Frosch入路组的手术时间略长,但特种外科医院膝关节评分和Rasmussen放射学评分优于扩大前外侧入路组。对于单纯后外侧骨折,两种入路均取得了良好的效果。对于复杂骨折,Frosch入路可能能够实现更精确的复位和更好的生物力学稳定性。

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本文引用的文献

1
CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study.基于 CT 的土耳其人群样本中后胫骨斜率分析:一项回顾性观察研究。
Medicine (Baltimore). 2023 Mar 31;102(13):e33452. doi: 10.1097/MD.0000000000033452.
2
A new strategy to fix posterolateral depression in tibial plateau fractures: Introduction of a new modified Frosch approach and a "Barrel hoop plate" technique.一种修复胫骨平台骨折后外侧平台塌陷的新策略:引入新的改良 Frosch 入路和“桶柄钢板”技术。
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3
Value of three-dimensional computed tomography reconstruction in the treatment of posterior tibial plateau fractures.
三维计算机断层扫描重建在胫骨平台后髁骨折治疗中的价值
Knee. 2020 Jan;27(1):3-8. doi: 10.1016/j.knee.2019.11.001. Epub 2019 Dec 26.
4
Comparative Analysis of Mechanism-Associated 3-Dimensional Tibial Plateau Fracture Patterns.三维胫骨平台骨折模式的机制相关比较分析。
J Bone Joint Surg Am. 2020 Mar 4;102(5):410-418. doi: 10.2106/JBJS.19.00485.
5
Surgical Treatment of Lateral Tibial Plateau Fractures Involving the Posterolateral Column.外侧胫骨平台骨折累及后外侧柱的手术治疗。
Orthop Surg. 2019 Dec;11(6):1029-1038. doi: 10.1111/os.12544. Epub 2019 Nov 6.
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How can the articular surface of the tibial plateau be best exposed? A comparison of specific surgical approaches.胫骨平台关节面如何能得到最佳显露?特定手术入路的比较。
Arch Orthop Trauma Surg. 2019 Oct;139(10):1369-1377. doi: 10.1007/s00402-019-03200-z. Epub 2019 May 17.
7
Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture.扩展前外侧入路治疗单纯/复杂胫骨平台骨折与胫骨平台后外侧骨折的比较
J Orthop Surg Res. 2018 Nov 28;13(1):303. doi: 10.1186/s13018-018-1007-7.
8
A biomechanical evaluation of different fixation strategies for posterolateral fragments in tibial plateau fractures and introduction of the 'magic screw'.胫骨平台骨折后外侧骨折块不同固定策略的生物力学评估及“神奇螺钉”的介绍
Knee. 2018 Jun;25(3):417-426. doi: 10.1016/j.knee.2018.03.015. Epub 2018 Apr 18.
9
Rim Plate Augmentation of the Posterolateral Bare Area of the Tibial Plateau Using a 3.5-mm Precontoured Locking Compression Plate: A Cadaveric Study.使用3.5毫米预塑形锁定加压钢板对胫骨平台后外侧裸区进行边缘钢板增强:一项尸体研究。
J Orthop Trauma. 2018 May;32(5):e157-e160. doi: 10.1097/BOT.0000000000001129.
10
Reinforcement strategy for lateral rafting plate fixation in posterolateral column fractures of the tibial plateau: The magic screw technique.胫骨平台后外侧柱骨折中外侧漂浮钢板固定的强化策略:神奇螺钉技术
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