摘要
目的观察膝关节韧带损伤时胫骨平台骨折的形态,探讨韧带损伤与胫骨平台骨折的关系以及3种胫骨平台骨折分型系统(Schatzker、AO和Duparc)的相关性。方法2015年12月—2017年12月沧州市人民医院骨科收治19例膝关节韧带损伤合并胫骨平台骨折患者的膝关节影像学图像,男性10例,女性9例;年龄17~59岁,平均39.4岁。按Schatzker、AO和Duparc系统分型,应用Spearman相关系数评价3个系统间的相关性,应用Logistic回归法评估骨折分型系统与韧带撕裂的关系以及评估韧带撕裂与胫骨平台骨折位置(内侧与外侧)的关系。结果3种胫骨平台分型系统(Schatzker、AO和Duparc)之间存在着合理的相关性。Schatzker系统下,骨折评分的提高与内侧副韧带(MCL)(P=0.056)和后外侧角(PLC)(P=0.035)的撕裂有显著的相关性。AO系统下骨折的分型与韧带撕裂之间无统计学意义。Duparc系统下,骨折评分的提高与MCL(P=0.032)和PLC(P=0.058)撕裂有显著的相关性。PLC撕裂与胫骨内侧平台骨折具有相关性(P=0.003)。MCL撕裂与胫骨外侧平台骨折具有相关性(P=0.004)。结论随着在Schatzker和Duparc胫骨平台骨折分型中级别的增加,MCL和PLC撕裂的可能性也随之增加。合并韧带损伤的胫骨平台骨折大多单发于胫骨内侧平台或外侧平台。胫骨内侧平台骨折与PLC撕裂有关,胫骨外侧平台骨折与MCL撕裂有关。
Objective To identify common morphologies of tibial plateau fractures that arise with multiligament knee injuries,and to investigate the relationship of the fracture with ligament tears and the correlation of 3 tibial plateau fracture classification systems(Schatzker,AO,and Duparc).Methods From Dec.2015 to Dec.2017,our department managed 19 multiligament knee injuries.There were 10 males and 9 females aged 17-59(average,39.4)years.Images of those knees with a tibial plateau fracture were retrospectively reviewed and classified per Schatzker,AO,and Duparc systems.Correlation among the 3 systems was evaluated using Spearman nonparametric correlation coefficient.Associations between fracture grading system and ligament tears were estimated using Logistic regression.Associations between ligament tears and tibial plateau fracture location(medial vs lateral)were estimated using exact Logistic regression.Results There was reasonable correlation among the 3 tibial plateau classification systems.Increasing grade under the Schatzker system showed statistically significant associations with medial collateral ligament(MCL)(P=0.056)and posterolateral corner(PLC)(P=0.035)tears.Increasing grade under the Duparc system showed statistically significant associations with MCL(P=0.032)and PLC(P=0.058)tears.PLC tears had a statistically significant association with medial plateau fractures(P=0.003).MCL tears had a statistically significant association with lateral plateau fractures(P=0.004).Conclusion The grade of designation increases within the Schatzker and Duparc tibial plateau fracture classifications,and the likelihood of MCL and PLC tear also inrease.The majority of tibial plateau fractures that occur in the context of MLKI are either isolated to the medial or lateral tibial plateau.Medial tibial plateau fractures are associated with PLC tears.Lateral tibial plateau fractures are associated with MCL tears.
作者
杨洋
冯青
李冕
冯红卫
刘宣毅
YANG Yang;FENG Qing;LI Mian;FENG Hong-wei;LIU Xuan-yi(Cangzhou People s Hospital,Cangzhou,Hebei 061000,China)
出处
《创伤外科杂志》
2019年第12期936-940,共5页
Journal of Traumatic Surgery
关键词
韧带拉伤
胫骨平台骨折
膝关节
分型
ligament injury
tibial plateau fractures
knee joint
classification
