Spier W, Muggler E
Langenbecks Arch Chir. 1977 Nov;345:409-14. doi: 10.1007/BF01305512.
Conservative management of considerably displaced tibial head fractures tends to stretch the ligaments and damage the soft tissue. Plateau steps impair mobility and lead to secondary osteoarthritis. Therefore operative procedures are prefered: A buttressing plate supports the displaced condyle after exposure and immaculate reduction. Impacted fragments call for elevation and underlining by cancellous graft. Postoperatively, early active motion and late weight bearing is the rule. Operative procedures will only produce satisfactory results when performed by an experienced surgeon.
对于移位明显的胫骨髁骨折，保守治疗往往会拉伸韧带并损伤软组织。平台台阶会损害活动能力并导致继发性骨关节炎。因此，手术治疗更受青睐：暴露并完美复位后，用支撑钢板支撑移位的髁。嵌插骨折块需要抬高并用松质骨移植进行支撑。术后，通常的做法是早期进行主动活动，后期进行负重。只有经验丰富的外科医生进行手术，才能取得满意的效果。
