手术时需要修复的外伤性半月板撕裂是胫骨平台骨折后中期随访预后较差的标志

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-09-17 DOI:10.1016/j.injury.2025.112763

Amaya M.Contractor BS , Steven Rivero , Philipp Leucht , Abhishek Ganta , Sanjit R. Konda , Kenneth A. Egol

{"title":"手术时需要修复的外伤性半月板撕裂是胫骨平台骨折后中期随访预后较差的标志","authors":"Amaya M.Contractor BS , Steven Rivero , Philipp Leucht , Abhishek Ganta , Sanjit R. Konda , Kenneth A. Egol","doi":"10.1016/j.injury.2025.112763","DOIUrl":null,"url":null,"abstract":"<div><div><em>Introduction</em>: The purpose of this study was to assess the effect of an acute traumatic meniscus tear that required repair in association with a tibial plateau fracture repair on outcomes.</div><div><em>Methods</em>: Over a 17-year period, 843 patients presented with a tibial plateau fracture and were followed prospectively. 721 patients with Schatzker I-VI fractures were treated operatively via a standardized algorithm. 161 tibial plateau fractures (22.3 %) had an associated meniscus tear that underwent acute repair at the time of bony fixation. These patients were compared to operatively repaired tibial plateau fracture patients with no meniscus injury (NMR). Demographics were collected and outcomes including: radiographic healing, knee range of motion (ROM), and complication rates, were recorded. In addition, re-operation rates were compared and any reoperation for meniscus repair failure identified. All patients had a minimum of 1 year follow up.</div><div><em>Results</em>: A total of 524 patients with a mean of 21.4 (range: 12–120) months follow up met inclusion criteria. Patients in the meniscus repair (MR) cohort had poorer knee extension (1.01 degrees, range: 0–30 degrees) compared to the NMR cohort (0.07 degrees, range: 0–10 degrees) (<em>p</em> < 0.001), in addition to poorer knee flexion (123 degrees, range: 0–145 degrees, <em>p</em> = 0.024). Additionally, MR patients reported higher pain scores (mean: 3 and range: 0–8, <em>p</em> = 0.005) at latest follow up. Finally, MR patients had higher rates of infection (8.1 % vs. 3.3 %, <em>p</em> = 0.025) and lateral collapse of the joint (<em>p</em> = 0.032).</div><div><em>Conclusion</em>: Patients who had a meniscus repair at the time of tibial plateau fracture repair were found to have poorer knee ROM, more patient reported pain at minimum 12 (mean 24) months post-operation. Additionally, these patients developed more post-operative complications than those patients who did not undergo a meniscus repair.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 11","pages":"Article 112763"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Traumatic meniscus tears requiring repair at the time of surgery are a marker of poorer outcome following Tibial plateau fracture at medium term follow up\",\"authors\":\"Amaya M.Contractor BS , Steven Rivero , Philipp Leucht , Abhishek Ganta , Sanjit R. Konda , Kenneth A. Egol\",\"doi\":\"10.1016/j.injury.2025.112763\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div><em>Introduction</em>: The purpose of this study was to assess the effect of an acute traumatic meniscus tear that required repair in association with a tibial plateau fracture repair on outcomes.</div><div><em>Methods</em>: Over a 17-year period, 843 patients presented with a tibial plateau fracture and were followed prospectively. 721 patients with Schatzker I-VI fractures were treated operatively via a standardized algorithm. 161 tibial plateau fractures (22.3 %) had an associated meniscus tear that underwent acute repair at the time of bony fixation. These patients were compared to operatively repaired tibial plateau fracture patients with no meniscus injury (NMR). Demographics were collected and outcomes including: radiographic healing, knee range of motion (ROM), and complication rates, were recorded. In addition, re-operation rates were compared and any reoperation for meniscus repair failure identified. All patients had a minimum of 1 year follow up.</div><div><em>Results</em>: A total of 524 patients with a mean of 21.4 (range: 12–120) months follow up met inclusion criteria. Patients in the meniscus repair (MR) cohort had poorer knee extension (1.01 degrees, range: 0–30 degrees) compared to the NMR cohort (0.07 degrees, range: 0–10 degrees) (<em>p</em> < 0.001), in addition to poorer knee flexion (123 degrees, range: 0–145 degrees, <em>p</em> = 0.024). Additionally, MR patients reported higher pain scores (mean: 3 and range: 0–8, <em>p</em> = 0.005) at latest follow up. Finally, MR patients had higher rates of infection (8.1 % vs. 3.3 %, <em>p</em> = 0.025) and lateral collapse of the joint (<em>p</em> = 0.032).</div><div><em>Conclusion</em>: Patients who had a meniscus repair at the time of tibial plateau fracture repair were found to have poorer knee ROM, more patient reported pain at minimum 12 (mean 24) months post-operation. Additionally, these patients developed more post-operative complications than those patients who did not undergo a meniscus repair.</div></div>\",\"PeriodicalId\":54978,\"journal\":{\"name\":\"Injury-International Journal of the Care of the Injured\",\"volume\":\"56 11\",\"pages\":\"Article 112763\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Injury-International Journal of the Care of the Injured\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020138325006217\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury-International Journal of the Care of the Injured","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020138325006217","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

简介：本研究的目的是评估需要修复的急性外伤性半月板撕裂与胫骨平台骨折修复对预后的影响。方法：在17年的时间里，843例胫骨平台骨折患者进行了前瞻性随访。通过标准化算法对721例Schatzker I-VI型骨折患者进行手术治疗。161例胫骨平台骨折（22.3%）伴有半月板撕裂，在骨固定时进行了急性修复。这些患者与手术修复的无半月板损伤的胫骨平台骨折患者（NMR）进行比较。收集了人口统计数据，记录了影像学愈合、膝关节活动范围（ROM）和并发症发生率。此外，我们还比较了半月板修复失败的再手术率和再手术率。所有患者至少随访1年。结果：524例患者，平均随访21.4个月（范围：12-120个月），符合纳入标准。与核磁共振组（0.07度，范围0-10度）相比，半月板修复组（MR）患者的膝关节伸直（1.01度，范围0-30度）较差（p < 0.001），此外膝关节屈曲较差（123度，范围0-145度，p = 0.024）。此外，MR患者在最近的随访中报告了更高的疼痛评分（平均：3，范围：0-8，p = 0.005）。最后，MR患者有更高的感染率（8.1%对3.3%,p = 0.025）和关节外侧塌陷（p = 0.032）。结论：在胫骨平台骨折修复时进行半月板修复的患者膝关节ROM较差，术后至少12个月（平均24个月）报告疼痛的患者较多。此外，这些患者比未接受半月板修复的患者出现更多的术后并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Traumatic meniscus tears requiring repair at the time of surgery are a marker of poorer outcome following Tibial plateau fracture at medium term follow up

Introduction: The purpose of this study was to assess the effect of an acute traumatic meniscus tear that required repair in association with a tibial plateau fracture repair on outcomes.

Methods: Over a 17-year period, 843 patients presented with a tibial plateau fracture and were followed prospectively. 721 patients with Schatzker I-VI fractures were treated operatively via a standardized algorithm. 161 tibial plateau fractures (22.3 %) had an associated meniscus tear that underwent acute repair at the time of bony fixation. These patients were compared to operatively repaired tibial plateau fracture patients with no meniscus injury (NMR). Demographics were collected and outcomes including: radiographic healing, knee range of motion (ROM), and complication rates, were recorded. In addition, re-operation rates were compared and any reoperation for meniscus repair failure identified. All patients had a minimum of 1 year follow up.

Results: A total of 524 patients with a mean of 21.4 (range: 12–120) months follow up met inclusion criteria. Patients in the meniscus repair (MR) cohort had poorer knee extension (1.01 degrees, range: 0–30 degrees) compared to the NMR cohort (0.07 degrees, range: 0–10 degrees) (p < 0.001), in addition to poorer knee flexion (123 degrees, range: 0–145 degrees, p = 0.024). Additionally, MR patients reported higher pain scores (mean: 3 and range: 0–8, p = 0.005) at latest follow up. Finally, MR patients had higher rates of infection (8.1 % vs. 3.3 %, p = 0.025) and lateral collapse of the joint (p = 0.032).

Conclusion: Patients who had a meniscus repair at the time of tibial plateau fracture repair were found to have poorer knee ROM, more patient reported pain at minimum 12 (mean 24) months post-operation. Additionally, these patients developed more post-operative complications than those patients who did not undergo a meniscus repair.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.