Abstract：Objective: To explore the main ligamentous injury characteristics in patients with Schatzker Type IV tibial plateau fracture accompanied by coronary knee dislocation. Methods: A total of 32 patients with Schatzker Type IV tibial plateau fracture accompanied by coronary knee dislocation, treated in our hospital from January 2019 to December 2022, were included in the study group. Additionally, 58 patients with isolated Schatzker Type IV tibial plateau fracture were selected as the control group. The two groups were analyzed and compared for cross ligament measurements, laxity coefficients, degree of knee cartilage injury, ligament function indicators, clinical indicators, knee HSS scores, and VAS scores. Results: There was no statistically significant difference in La, Da, and Dp between the two groups (P>0.05). However, the study group showed higher values for Lp, TCa, and TCp compared to the control group (P<0.05). Analysis of knee cartilage injury revealed no statistically significant difference between the two groups (P>0.05). Before treatment, there was no significant difference in the peak torque ratio of flexors/extensors and limb symmetry index between the two groups (P>0.05). After treatment, both groups showed improved ligament function, with the study group exhibiting a greater increase in peak torque ratio and limb symmetry index compared to the control group (P<0.05). Clinical indicators, including operation time, intraoperative blood loss, postoperative hospitalization time, fracture healing time, and postoperative complication rate, showed no significant difference between the two groups (P>0.05). There was no statistically significant difference in HSS scores before and 6 months after treatment between the two groups (P>0.05). However, compared to the control group, the study group had lower HSS scores at 7 days, 1 month, and 3 months postoperatively (P<0.05). Similarly, there was no significant difference in VAS scores before and 6 months after treatment between the two groups (P>0.05). Compared to the control group, the study group had higher VAS scores at 7 days, 1 month, and 3 months postoperatively (P<0.05). Conclusion: Compared to patients with isolated Schatzker Type IV tibial plateau fractures, those with Schatzker Type IV tibial plateau fractures accompanied by coronary knee dislocation exhibited higher postoperative Lp, TCa, and TCp values, worse ligament recovery, poorer knee joint function, and greater short-term pain. These patients require additional attention.
郑权, 孙良业. 伴冠状面膝关节脱位的Schatzker Ⅳ型胫骨平台骨折患者主要韧带损伤特点临床研究[J]. 河北医学, 2023, 29(12): 2033-2038.
ZHENG Quan, SUN Liangye. Clinical Study on Main Ligament Injury Characteristics of Schatzker Type Ⅳ Tibial Plateau Fracture with Coronal Knee Dislocation. HeBei Med, 2023, 29(12): 2033-2038.
[1] 张宇,胡军,洪顾麒,等.前外联合后内侧入路复位内固定治疗伴冠状面半脱位的Wahlquist C型内侧胫骨平台骨折[J].中华骨科杂志,2022,42(6):349-356. [2] Deng X T,Zheng Z Z,Shao D C,et al.Arthroscopic evaluation of tibial plateau fractures combined with meniscal tears and cruciate ligamentous injuries[J].Chinese journal of surgery,2021,59(6):464-469. [3] Van den Berg J,De Boer AS,Assink N,et al.Trauma mechanism and patient reported outcome in tibial plateau fractures with posterior involvement[J].The Knee,2021,30(8):41-50. [4] Chouhan D K,Hooda A.Dual split and dislocation a variant of Schatzker type-1 tibial plateau fracture:a case report[J].Chin Traumatol,2022,25(1):59-62. [5] 黄飞,吴伟,郭大静,等.磁共振三维选择性水激发序列在膝关节软骨损伤中的应用价值[J].第三军医大学学报,2021,43(9):871-875. [6] 裴璇,汪国栋,钱胜龙等.经外侧平台非核心负重区截骨复位内固定治疗伴后外侧柱塌陷的胫骨平台骨折[J].中国修复重建外科杂志,2023,37 (4):410-416. [7] 葛新江,游建军,刘晓峰,等.关节镜辅助MIPPO技术治疗老年Schatzker Ⅱ~Ⅲ型胫骨平台骨折的疗效及预后研究[J].中国临床解剖学杂志,2021,39(3):342-345,350. [8] 沈啟捷,舒衡生,邢国胜,等.关节镜辅助复位内固定治疗胫骨平台骨折相关问题[J].中国矫形外科杂志,2022,30(8):722-726. [9] 邓翔天,郑占乐,邵德成,等.关节镜下评估胫骨平台骨折合并半月板撕裂和交叉韧带损伤的临床研究[J].中华外科杂志,2021,59(6):464-469. [10] 姜铃霞,姚伟武,曹励欧,等.交叉韧带撕裂合并膝关节后外侧韧带复合体损伤的磁共振评价[J].放射学实践,2023,38(2):198-203. [11] 靳莉丹,申瑞田.三维CT联合MRI分析膝关节ACL损伤重建术后移植物、周围结构与膝关节稳定性关系[J].影像科学与光化学,2022,40(2):418-423.
2023, Vol. 29 
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