Radiographic Prediction of Soft Tissue Injury Associated with Tibial Plateau Fractures: The Direction of Articular Depression Matters.

Matthew P Lunati, Jesse Seilern Und Aspang, J'Lynn L Baker, Jacob M Wilson, Thomas J Moore
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Abstract

This investigation aimed to evaluate the impact of coronal articular fragment displacement of Schatzker type II tibial plateau fractures on concomitant soft tissue knee injuries. One hundred consecutively treated patients were included. Depression depth and coronal articular fragment displacement were measured radiographically, and medial collateral ligament (MCL) and lateral meniscus (LM) injury, and pain and range of motion (ROM) on final follow up, were recorded. Multivariable regression was then performed. Coronal articular fragment displacement was medially and laterally hinged in 74% and 26% of patients, respectively. MCL injuries were significantly higher in the lateral hinge group (odds ratio [OR]: 3.25; confidence interval [CI]: 1.07 to 9.84; p = 0.03). No difference was found in LM injury incidence and amount of articular depression between groups. At final follow-up, average pain and ROM was similar between groups. Findings demonstrate a significant correlation between laterally hinged articular depression in Schatzker II tibial plateau fractures and concomitant MCL injury. (Journal of Surgical Orthopaedic Advances 32(4):270-275, 2023).

胫骨平台骨折相关软组织损伤的影像学预测:关节凹陷的方向很重要。
本研究旨在评估 Schatzker II 型胫骨平台骨折冠状关节碎片移位对并发膝关节软组织损伤的影响。研究纳入了 100 名连续接受治疗的患者。对凹陷深度和关节片冠状位移进行放射学测量,并记录内侧副韧带(MCL)和外侧半月板(LM)损伤情况以及最后随访时的疼痛和活动范围(ROM)。然后进行多变量回归。分别有74%和26%的患者的冠状关节片移位呈内侧和外侧铰链状。外侧铰链组的MCL损伤率明显更高(几率比[OR]:3.25;置信区间[CI]:1.07至9.84;P = 0.03)。各组之间的 LM 损伤发生率和关节凹陷量没有差异。在最后的随访中,各组的平均疼痛和关节活动度相似。研究结果表明,Schatzker II型胫骨平台骨折的侧铰链关节凹陷与并发的MCL损伤之间存在明显的相关性。(外科骨科进展杂志》32(4):270-275,2023)。
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