Padanilam T G, Ebraheim N A, Frogameni A
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
Clin Orthop Relat Res. 1995 May(314):192-8.
This retrospective study evaluated 18 patients in whom an extensile approach to the lateral tibial plateau involving anterior detachment and retraction of the lateral meniscus was used to improve visualization of the tibial articular surface. All patients in this study had a significantly comminuted tibial plateau fracture with a minimum articular depression of 10 mm. Four of the 18 patients had peripheral meniscal tears that were repaired at the time of tibial fixation. All patients had a minimum followup of 13 months. The average range of motion was 0 degrees to 117 degrees. None of the patients had evidence of meniscal symptoms. Functional evaluation revealed that 13 of the patients had an excellent result, 5 had a good result, and 1 a poor result. Five patients evaluated with arthroscopy showed complete healing of the anteromedial detachment site of the meniscus. Two of the 5 patients also had a meniscal repair that healed. For patients in whom there is significant comminution and depression of the lateral tibial plateau, this is a safe and effective method of treatment that provides excellent exposure of the articular surface to allow an accurate reduction.
这项回顾性研究评估了18例患者，这些患者采用了一种广泛的外侧胫骨平台入路，包括外侧半月板的前部松解和牵开，以改善胫骨关节面的可视化。本研究中的所有患者均有严重粉碎性胫骨平台骨折，关节面至少塌陷10 mm。18例患者中有4例存在半月板周边撕裂，在胫骨固定时进行了修复。所有患者的随访时间至少为13个月。平均活动范围为0度至117度。所有患者均无半月板症状的迹象。功能评估显示，13例患者结果为优，5例为良，1例为差。5例接受关节镜检查的患者显示半月板前内侧松解部位完全愈合。5例患者中有2例半月板修复也已愈合。对于外侧胫骨平台存在严重粉碎和塌陷的患者，这是一种安全有效的治疗方法，可提供良好的关节面暴露，以便进行准确复位。
