A review of the management of tibial plateau fractures.
A review of the management of tibial plateau fractures.
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DOI：
10.1007/s12306-017-0514-8
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发表时间：
2018-08-01
影响因子：
--
通讯作者：
Chikate, A
中科院分区：
文献类型：
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作者：
Mthethwa, J;Chikate, A
胫骨平台骨折形成了各种各样的损伤，给创伤外科医生带来了不同的挑战。这种损伤谱的预后在很大程度上取决于对每种特殊结构的管理，因此文献中充斥着一些共识有限的管理策略。这篇综述的目的是根据国际骨科杂志上最新和经典的同行评议出版物，为创伤外科医生提供一个简明的指南。进行了PubMed搜索，以识别过去10年内经过同行审查的出版物，并扩大到识别与沙茨克分类有关的经典论文。重点是基于管理技术、争议和最新发展的文章。对特定损伤类型的管理基于Schatzker分类，这是一种被广泛接受的传统分类系统。虽然对这类骨折的稳定解剖复位的最终目标达成了普遍共识，但围绕着一些问题仍然存在争议，包括术前影像、初步评估和特定损伤类型的最终处理，其中一些不符合最初的Schatzker分类。大多数骨折需要手术治疗，无论采用何种治疗策略，主要强调尊重软组织包膜。比较不同可用手术技术的前瞻性随机对照试验仍然很少。
Tibial plateau fractures form a wide spectrum of injuries presenting varying challenges to the trauma surgeon. The prognosis of this injury spectrum is largely dependent on the management of each particular configuration, and the literature is as a result littered with a number of management strategies with limited consensus. The aim of this review is to provide a concise guide to the trauma surgeon based on newer and classical peer-reviewed publications in international orthopaedic journals. A PubMed search was conducted to identify peer-reviewed publications within the last 10years and expanded to identify classic papers pertaining to the Schatzker classification. The focus was on articles based on management techniques, controversies and recent developments. The management of specific injury patterns is based on the Schatzker classification which is a widely accepted traditional classification system. Whilst there is a general consensus on the ultimate goal of a stable anatomic reduction in this subset of fractures, there continues to be a number of controversies surrounding issues including pre-operative imaging, initial assessment and definitive management of specific injury patterns, some of which do not conform to the original Schatzker classification. The majority of fractures will require operative management, and with whatever management strategy employed, the main emphasis is on respecting the soft tissue envelope. There remains a paucity of prospective randomised controlled trials comparing the different available operative techniques.