摘要
目的观察膝关节多韧带损伤时胫骨平台骨折的形态,探讨胫骨平台骨折类型与韧带撕裂的相关性,同时分析3种胫骨平台骨折分类系统(Schatzker、AO、Duparc)的相关性。方法回顾性分析自2015-12—2017-12诊治的19例膝关节韧带损伤合并胫骨平台骨折。胫骨平台骨折分别按Schatzker、AO、Duparc系统分类,采用Spearman相关系数分析系统间的相关性,采用Logistic回归法估计骨折分级系统、胫骨平台骨折位置(内侧与外侧)与韧带损伤的关系。结果胫骨平台骨折Schatzker、AO、Duparc分类系统之间存在着合理的相关性。胫骨平台骨折Schatzker、Duparc分级的增加与内侧副韧带(MCL)、后外侧复合体(PLC)损伤存在相关性,而与前交叉韧带(ACL)、后交叉韧带(PCL)损伤无相关性。胫骨平台骨折AO分级与膝关节韧带损伤无相关性。ACL撕裂(P=0.110)、PCL撕裂(P=0.270)与胫骨平台骨折位置(内侧与外侧)无相关性,PLC撕裂(P=0.003)、MCL撕裂(P=0.004)与胫骨内侧平台骨折发生存在相关性。结论随着胫骨平台骨折Schatzker分型和Duparc分型等级的增高,膝关节MCL和PLC撕裂的可能性也随之增加。大多数胫骨平台骨折患者合并的膝关节多韧带损伤单发于内侧或外侧胫骨平台,胫骨内侧平台骨折与PLC撕裂相关,胫骨外侧平台骨折与MCL撕裂相关。
Objective To observe the relationship between multiple ligament injuries of knee and fracture morphology of tibia plateau,investigate the correlation between fracture types of tibia plateau and ligament tear and analyze the correlation of three kinds of tibia plateau fracture classification system(Schatzker,AO,Duparc).Methods From December 2015 to December 2017,19 patients with knee ligament injuries complicated with tibia plateau fracture were treated in our hospital.Those tibial plateau fractures were 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 and the Duparc system showed statistically significant associations with medial collateral ligament(MCL)and posterolateral corner(PLC)tears,but not with anterior cruciate ligament(ACL)(P=0.110)and posterior cruciate ligament(PCL)tears(P=0.270).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 As the grade of designation increases within the Schatzker and Duparc tibial plateau fracture classifications,as does the likelihood of MCL and PLC tear.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(Department of Orthopedics,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)
出处
《中国骨与关节损伤杂志》
2020年第2期124-128,共5页
Chinese Journal of Bone and Joint Injury
关键词
胫骨平台骨折
膝关节内侧副韧带
膝关节后外侧角
前交叉韧带
后交叉韧带
SCHATZKER分型
AO分型
Duparc分型
Tibial plateau fractures
Medial collateral ligament of knee
Posterolateral corner of knee
Anterior cruciate ligament
Posterior cruciate ligament
Schatzker classification
AO classification
Duparc classification
