Operative treatment of 109 tibial plateau fractures: Five- to 27-year follow-up results
Operative treatment of 109 tibial plateau fractures: Five- to 27-year follow-up results
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DOI：
10.1097/bot.0b013e31802c5b51
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发表时间：
2007-01-01
影响因子：
2.3
通讯作者：
Marti, R. K.
中科院分区：
文献类型：
--
作者：
Rademakers, M. V.;Kerkhoffs, G. M. M. J.;Marti, R. K.
目的：分析长期（5-27年）的功能和影像学结果的手术治疗骨折的胫骨platelet.Design：回顾性研究。设置：大学hospital.Patients和方法：202个连续胫骨平台骨折纳入本研究。根据AO和Schatzker分类对所有骨折进行分类。其中男性112人，女性90人。受伤时的平均年龄为46岁（16至88岁）。163例患者为孤立性骨折，39例为多发性骨折。对所有202例患者进行了1年随访。其中109例患者还接受了额外的长期随访。这109名患者的功能结果与Neer和HSS膝关节评分分级。放射学结果采用Ahlbäck评分进行分级。通过SPSS数据分析程序进行统计分析。结果：95%的患者在1年随访时顺利愈合，沿着平均膝关节ROM为130度（范围：10-145度）。109例患者在平均14年（范围，5-27年）后接受了长期随访。此时的平均ROM为135度（范围：0-145度）。功能结果显示平均Neer评分为88.6分（范围，56-100分），平均HSS评分为84.8分（范围，19-100分）。与双髁骨折相比，单髁骨折的功能结果在统计学上显著更好。31%的患者发生继发性骨关节炎，但大多数患者耐受良好（64%的患者）。与膝关节解剖轴的患者（9.2%; MWU，P= 0.02）相比，对线不良超过5度的患者（27%的患者）发生中度至重度骨关节炎的频率更高，具有统计学显著性。年龄似乎没有任何影响的结果。结论：胫骨平台骨折切开复位内固定后的长期结果是优秀的，独立于患者的年龄。
Objective:To analyze the long-term (5-27 years) functional and radiologic results of surgically treated fractures of the tibial plateau.Design:Retrospective study.Setting:University hospital.Patients and Methods:Two hundred two consecutive tibial plateau fractures were included in this study. All fractures were classified according to both the AO and the Schatzker classification. There were 112 men and 90 women. The mean age at injury was 46 years (16 to 88). One hundred sixty-three patients had isolated fractures and 39 had multiple fractures. A 1 year follow-up was done in all 202 patients. One hundred nine of these patients also had an additional long-term follow-up visit. Functional results of these 109 patients were graded with the Neer-and HSS-knee scores. Radiologic results were graded with the Ahlbäck score. Statistical analysis was performed by means of the SPSS data analysis program.Results:An uneventful union was present at the 1 year follow-up in 95% of the patients, along with a mean knee ROM of 130 degrees (range, 10-145 degrees). One hundred nine patients had a long-term follow-up visit after a mean period of 14 years (range, 5-27 years). The mean ROM at this time was 135 degrees (range, 0-145 degrees). Functional results showed a mean Neer score of 88.6 points (range, 56-100 points) and a mean HSS score of 84.8 points (range, 19-100 points). Monocondylar fractures showed statistically significant better functional results compared to bicondylar fractures. In 31% of the patients, secondary osteoarthritis had developed but was well tolerated in most (64% of the patients). Patients with a malalignment of more then 5 degrees developed a moderate to severe grade of osteoarthritis statistically significant more often (27% of the patients) compared to patients with an anatomic knee axis (9.2%; MWU, P= 0.02). Age did not appear to have any influence on the results.Conclusion:Long-term results after open reduction and internal fixation for tibial plateau fractures are excellent, independent of the patient's age.