摘要
胫骨平台骨折后常合并韧带、半月板损伤,引起膝关节失稳,远期将导致创伤性关节炎。胫骨平台骨折的治疗,应遵循骨折与关节周围软组织损伤的全修复理念,骨折复位与固定是基础,同时应全面评估关节内外韧带、半月板等软组织创伤,及时进行修复,重建关节的稳定性。胫骨平台骨折的治疗应注重利用各种复位技术对平台关节面塌陷和矢状面成角的精细复位,钢板螺钉选择依据骨折形态与特性,外固定架的使用需掌握好适应证。对于半月板,应尽量保留修补,对于韧带损伤应一期修复,必要时二期重建。胫骨平台骨折合并韧带半月板损伤的发生规律尚不明确,因此必须全面评估骨折、韧带与半月板损伤,同时借助三维CT与MRI表现去诠释其损伤模式及相关机制,遵循整体治疗原则,采取个性化方案,期望达到更好的治疗效果。
Tibial plateau fracture usually accompanied with ligament and meniscus injuries lead to the instability of the knee joint, and traumatic arthritis further. The overall repair concept for the fracture and soft tissue should be followed during the treatment of the tibial plateau fracture. Comprehensive assessment and timely repair of injured the ligament and meniscus to restore the joint stability is necessary based on the reduction and fixation of fracture. The tibial plateau fracture need be accurately reduced to correct the collapse joint surface and sagittal plane angle, firmly fixed using various fixation techniques, such as screws, locking plate and external fixation with appropriate indication according to the fracture features. In addition, the meniscus should be preserved as far as possible, while the torn ligament should be early repaired or delayed reconstructed. Till now the characteristics of soft tissue injuries accompanied with tibial plateau fracture is not completely clear. After the comprehensive assessment of the fracture and soft tissue injury based on 3 D CT and MRI to analyze the injury mechanism, personalized treatment strategies are formulated based on overall principles to improve the clinical consequences.
作者
崔猛
GUI Meng(The Second Division of Knee,Department of Traumatic Orthopaedic,Tianjin Hospital,Tianjin 300211,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第16期1483-1488,共6页
Orthopedic Journal of China
关键词
胫骨平台骨折
复位
固定
韧带
半月板
tibial plateau fracture
reduction
fixation
meniscus
ligament
