胫骨平台骨折时股骨髁损伤的发生率。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-10-09 DOI:10.1016/j.knee.2024.09.009

Mees Paulus Emmelot , Robert Kaspar Wagner , Frank Floris Smithuis , Robert Hemke , Stein Jasper Janssen , Peter Kloen

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引用次数: 0

摘要

背景：胫骨平台骨折模式受撞击方向、能量和骨质的影响。同样的撞击也可能导致相关的股骨关节损伤，但相关研究尚不充分。本研究量化了三种不同的股骨髁关节损伤的发生率：（1）撞击骨折，（2）挫伤和（3）髁骨折。我们对撞击性骨折的深度、宽度、长度和表面积进行了评估：我们对在一家三级创伤中心接受胫骨平台骨折手术的患者进行了回顾性研究。两名接受过研究培训的放射科医生对术前CT扫描进行了分析，以确定是否存在相关的股骨髁损伤。我们对以下情况进行了定义：（1）撞击性骨折（凹陷≥ 1.5 毫米），伴有硬化带、骨折线或两者；（2）挫伤（凹陷）：我们确定了 149 名有 CT 扫描结果的胫骨平台骨折患者（62 名男性）。股骨髁关节损伤的总发病率为 26%（n = 39）。撞击骨折发生率为9.4%（n = 14），挫伤发生率为14%（n = 21），髁状骨折发生率为3.0%（n = 4）。股骨髁损伤发生率较高的相关因素是年龄较小（p = 0.029）、男性（p = 0.014）和无合并症（p = 0.005）。撞击性骨折的平均深度为2.3毫米（SD：0.78；范围为1.6至4）：结论：每四名胫骨平台骨折患者中就有一名合并股骨髁关节损伤。虽然大多数股骨损伤并不明显，也没有人接受手术治疗，但这些损伤可能隐藏着未来关节退化和膝关节不稳定的可能性：证据等级：IV。

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Prevalence of femoral condyle injuries in the setting of tibial plateau fractures

Background

Tibial plateau fracture patterns are influenced by the direction and energy of the impact, and the bone quality. Associated articular femoral injuries can result from the same impact but are insufficiently studied. This study quantifies the prevalence of three distinct articular femoral condyle injuries: (1) impaction fractures, (2) contusions, and (3) condyle fractures. For impaction fractures we assessed the depth, width, length, and surface area.

Methods

We retrospectively reviewed patients who had undergone surgery for a tibial plateau fracture in a tertiary trauma center. Two fellowship-trained radiologists analyzed preoperative CT scans for associated femoral condyle injuries. We defined (1) impaction fractures (depressions ≥ 1.5 mm) with a sclerotic band, a fracture line, or both; (2) contusions (depressions < 1.5 mm) with a sclerotic band; and (3) condyle fractures as sub- or osteochondral fractures.

Results

We identified 149 patients (62 male) with a tibial plateau fracture with a CT scan available. The overall prevalence of articular femoral condyle injuries was 26% (n = 39). The prevalence of impaction fractures was 9.4% (n = 14), of contusions 14% (n = 21), and of condylar fractures 3.0% (n = 4). Factors associated with a higher prevalence of femoral condyle injury were younger age (p = 0.029), male sex (p = 0.014), and absence of comorbidity (p = 0.005). The mean depth of impaction fractures was 2.3 mm (SD: 0.78; range 1.6 to 4).

Conclusion

Concomitant articular femoral condyle injuries occur in one out of four patients with a tibial plateau fracture. Although most femoral injuries were subtle, and none underwent surgical treatment, they might harbor information regarding the likelihood of future joint degeneration and knee instability.

Level of evidence: IV.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.