Scheerlinck T, Ng C S, Handelberg F, Casteleyn P P
Department of Orthopaedics and Traumatology, Academic Hospital, Free University of Brussels, Belgium.
J Bone Joint Surg Br. 1998 Nov;80(6):959-64. doi: 10.1302/0301-620x.80b6.8687.
We carried out percutaneous, arthroscopically- and fluoroscopically-assisted osteosynthesis of fractures of the tibial plateau in 52 patients, of whom 38 were assessed using the HSS knee score and standing radiographs. We reviewed 31 AO type-B fractures and seven type-C fractures after a mean follow-up of five years (1 to 14). Fixation was achieved using percutaneous screws and/or an external frame; 33 associated intra-articular injuries, diagnosed in 21 out of the 38 patients, were treated arthroscopically. Subjectively, 94.7% of the patients reviewed were satisfied. According to the HSS knee score 78.9% of the results were excellent, 13.2% good, 7.9% fair and none was poor. Narrowing of the joint space was found in 28.9% of the injured and 5.3% of the unaffected knees and axial deviation of 5 degrees to 10 degrees in 15.8% of the injured and 10.5% of the unaffected knees. Of the 52 fractures, reduction was incomplete in one, and in two secondary displacement occurred, of which one required corrective osteotomy. Deep-venous thrombosis occurred in four cases. The technique has proved to be safe but demanding. It facilitates diagnosis and appropriate treatment of associated intra-articular lesions.
我们对52例胫骨平台骨折患者进行了经皮、关节镜辅助和透视辅助下的骨折内固定术，其中38例患者采用HSS膝关节评分和站立位X线片进行评估。我们回顾了31例AO B型骨折和7例C型骨折，平均随访5年（1至14年）。使用经皮螺钉和/或外固定架实现固定；38例患者中有21例诊断出33处相关的关节内损伤，通过关节镜进行治疗。主观上，接受复查的患者中有94.7%表示满意。根据HSS膝关节评分，78.9%的结果为优，13.2%为良，7.9%为中，无差的结果。在受伤膝关节中，28.9%出现关节间隙变窄，在未受伤膝关节中为5.3%；在受伤膝关节中，15.8%出现5度至10度的轴向偏差，在未受伤膝关节中为10.5%。52处骨折中，1处复位不完全，2处出现二次移位，其中1处需要进行截骨矫正。4例发生深静脉血栓形成。该技术已被证明是安全的，但要求较高。它有助于诊断和适当治疗相关的关节内病变。
