|
|
|
Abstract Objective To investigate the clinical characteristics and treatment of hyperextension valgus tibial plateau fracture.Methods Data of 11 patients with hyperextension and eversion tibial plateau fracture admitted to our hospital from January 2016 to December 2020 was retrospectively analyzed.7 males and 4 females were included.The patients aged from 24 to 65 years，with an average of (50.4±5.7) years.Fractures were treated with open reduction，bone graft，plate and screw internal fixation.Concomitant avulsion fractures of the femoral condyle were treated with conservative treatment or further internal fixation according to the intraoperative conditions.Regular follow-up was performed to record the time of fracture healing and the occurrence of complications.Visual analogue score(VAS)，range of motion(ROM)，hospital for special surgery(HSS) knee score to evaluate the clinical efficacy.Results All 11 patients were followed up for 12 to 18 months，with an average of (10.4±4.8) months.Fracture healing time ranged from 12 to 15 weeks，with an average of (11.8±4.5) weeks.There were no postoperative complications such as incision infection，internal fixation failure and fracture nonunion.VAS score gradually decreased，knee HSS score and knee flexion and extension activity gradually increased，with statistical significance at different time points (P＜0.01).At the last followup，all patients had good stability of knee joint，no abnormality of lower limb force line and gait，no stiffness of knee joint，and could squat completely.Conclusion Tibial plateau fracture with hyperextension and eversion is a very rare type of injury in clinic.It is often associated with avulsion fracture of medial femoral condyle.A full understanding of the mechanism of coronal diagonal injury and standardized treatment can achieve satisfactory results.
|
|
|
|
Corresponding Authors:
Xu Qiang
|
|
|
|
［1］蒋靓君，朱晗晓，陈尔曼，等.非脱位过伸型胫骨平台骨折的临床特征及治疗［J］.中华骨科杂志，2020，40(18)：1266-1274.
［2］陈晓斌，林宜磒，王晓伟，等.过伸型胫骨平台骨折的临床治疗分析［J］.实用骨科杂志，2020，26(10)：880-883.
［3］Gonzalez LJ，Lott A，Konda S，et al.The hyperextension tibial plateau fracture pattern：A predictor of poor outcome［J］.J Orthop Trauma，2017，31(11)：e369-e374.
［4］洪顾麒，吕天润，宋李军.经前内及前外侧联合入路治疗复杂过伸型胫骨平台骨折［J］.中华创伤骨科杂志，2020，22(8)：687-692.
［5］宋伟毅，牛鸣，林晓航，等.胫骨平台前内侧压缩骨折合并膝关节后外复合体损伤的治疗策略［J］.中华创伤骨科杂志，2021，23(9)：813-816.
［6］王辉，邹宏，沈建平，等.膝关节对角线损伤中后外侧复合体损伤一期手术疗效观察［J］.中国骨与关节损伤杂志，2019，34(10)：1029-1032.
［7］王耀宗，张英.悬垂体位撬拨法治疗过伸型胫骨平台骨折［J］.中华骨科杂志，2019，39(2)：83-89.
［8］蒋协远，王大伟.骨科临床疗效评价标准［M］.北京：人民卫生出版社，2005：177-178.
［9］罗从风，胡承方，高洪，等.基于CT的胫骨平台骨折的三柱分型［J］.中华创伤骨科杂志，2009，11(3)：201-205.
［10］张世民，胡孙君，杜守超，等.过伸型胫骨平台骨折研究进展［J］.中国修复重建外科杂志，2018，32(4)：495-500.
［11］周汇霖.胫骨平台骨折分型的研究进展［J］.河北医科大学学报，2019，40(9)：1099-1103.
［12］徐强.胫骨平台骨折的分型原理及临床研究［M］.成都：四川科学技术出版社，2020：56-61.
［13］徐强，肖鹏，刘磊，等.胫骨平台骨折十字类型Ⅲe型的DR阅片研究［J］.中国矫形外科杂志，2019，27(16)：1527-1530.
［14］徐强，王晓刚，刘颖，等.合并股骨内髁撕脱骨折的胫骨平台骨折的十字类型特征研究［J］.中华创伤骨科杂志，2019，21(12)：1073-1076.
［15］王晓刚，徐强，张清晏，等.切开复位钢丝张力带内固定治疗膝关节对角线损伤合并的腓骨头弓状撕脱骨折［J］.中医正骨，2021，33(10)：70-73.
［16］姜文斌，孙诗竹，宋亭薇，等.腘肌肌腱复合体的解剖学观察及其临床意义［J］.解剖学杂志，2021，44(S1)：72-76.
［17］邵嘉艺，张家豪，任爽，等.膝关节内侧副韧带浅层(sMCL)止点的解剖学及有限元分析［J］.中国运动医学杂志，2020，39(2)：93-96. |
| [1] |
. [J]. sygkzz, 2022, 28(3): 266-281. |
|
|
|
���������� 14010702070875��