合并晚期膝关节病的胫骨近端应力骨折的分型与治疗

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Abstract Objective Management options of gonarthrosis with proximal tibia stress fracture are ill-defined.In this study，a new classification was proposed based on characteristics of 18 cases of gonarthrosis complicated by proximal tibia stress fracture.Methods From Aug 2011 to Jan 2015，a total of 18 cases of knee arthritis combined with ipsilateral tibia stress fracture were included，including 7 male and 11famale，with an average age of 66 years old(ranging from 62~71 years).In the 18 patients，8 patients underwentexcision of fracture fragment followed by rugular TKA.1 patients were treated by modulated TKA with a long stem and metal augments.TKA with a long stem were applied to 6 patients with extraarticular fracture and another 3 patients were added plate and screws.Results The patients were followed up for 12.3 months (from 3 to 21 months).Gonoarthrosis with proximal tibia stress fracture can be classified as intra-and extra-articular fracture.The former was then classified into segemental and marginal type.The later were then subdivided into stable and unstable type.After treatment according to the classification，average Knee Society Score improved from 23.62 to 80.87；and average functional score improved from 18.75 to 81.75.Conclusion Under the instruction of this simple classification，modulated TKA with or without internal fixtion can be used successfully to treat severe gonoarthrosis with proximal tibia stress fracture.

Key words： knee arthropathy stress fracture total knee arthroplasty

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