Schwartsman R, Brinker M R, Beaver R, Cox D D
Department of Orthopaedic Surgery, University of Texas, Houston Health Science Center, USA.
Am J Orthop (Belle Mead NJ). 1998 Jul;27(7):512-9.
This retrospective study examined the outcome of 40 patients 50 or more years of age treated between September 1988 and September 1993 for tibial plateau fractures. Our analysis was based on a review of the medical records of all patients as well a patient self-assessment questionnaire. The 22 women and 18 men studied had a mean age of 60 (range, 50 to 76 years) at the time of injury. A satisfactory overall outcome (based on patients' self-assessment) was observed in only 14 (35%) of the 40 cases. Unsatisfactory outcomes were observed in 23 (72%) of 32 cases treated operatively and 3 (38%) of 8 cases treated nonoperatively. No significant difference in outcome was observed between the 27 patients with AO type B fractures and the 13 patients with AO type C fractures. Similarly, no significant difference in outcome was observed in patients with fractures involving the lateral plateau only, those with fractures involving the medial plateau only, and those with bicondylar fractures. There was no significant relationship between the adequacy of fracture reduction and overall clinical outcome, although a trend of more favorable outcomes was noted in patients with excellent or satisfactory reductions. The results suggest that patients of 50 or more years of age have a high rate of unsatisfactory clinical outcomes regardless of how their tibial plateau fractures are treated.
这项回顾性研究调查了1988年9月至1993年9月期间接受治疗的40例年龄在50岁及以上的胫骨平台骨折患者的治疗结果。我们的分析基于对所有患者病历的审查以及一份患者自我评估问卷。所研究的22名女性和18名男性在受伤时的平均年龄为60岁（范围为50至76岁）。在40例病例中，仅有14例（35%）观察到总体结果令人满意（基于患者自我评估）。在接受手术治疗的32例病例中有23例（72%）观察到结果不满意，在接受非手术治疗的8例病例中有3例（38%）观察到结果不满意。AO B型骨折的27例患者与AO C型骨折的13例患者之间在结果上未观察到显著差异。同样，仅涉及外侧平台骨折的患者、仅涉及内侧平台骨折的患者以及双髁骨折的患者在结果上也未观察到显著差异。骨折复位的充分程度与总体临床结果之间没有显著关系，尽管在复位优秀或满意的患者中观察到了更有利结果的趋势。结果表明，50岁及以上的患者无论其胫骨平台骨折如何治疗，临床结果不满意的发生率都很高。
