医学
可视模拟标度
胫骨平台骨折
撞击
外科
组内相关
伤口裂开
内固定
射线照相术
口腔正畸科
临床心理学
心理测量学
作者
Timothy Bhattacharyya,McCarty Lp,Harris Mb,Morrison Sm,Wixted Jj,Vrahas Ms,Smith Rm
出处
期刊:PubMed
日期:2005-05-14
卷期号:19 (5): 305-10
被引量:53
摘要
This study was designed to describe the fracture patterns and early results of treatment of posterior shearing tibial plateau fractures.Retrospective case series.Tertiary care hospital.Thirteen patients identified from prospective trauma database with posterior shearing tibial plateau fractures.Open reduction and internal fixation through a posterior approach to the knee.Functional outcome assessed by Musculoskeletal Functional Assessment score and Visual Analogue Scale pain scores. Clinical and radiographic outcome.A consistent fracture pattern was identified with a primary, inferiorly displaced posteromedial shear fracture with variable amounts of lateral condylar impaction. The average duration of clinical patient follow-up was 20 (range, 13-27) months. All fractures healed after index surgery. Two complications (1 wound dehiscence and 1 flexion contracture) were all managed nonoperatively. Three independent surgeons graded patients' articular reduction, with good interobserver reliability (intraclass correlation coefficient = 0.82). The average Musculoskeletal Function Assessment dysfunction score for the 9 patients who responded was 19.5/100, and average resting Visual Analogue Scale pain score was 1.8 cm/10 cm, indicating good function. The functional outcome score was significantly related to the quality of articular reduction (P < 0.017, R = 0.456).Posterior shearing tibial plateau fractures form a consistent pattern. They can be successfully managed using a posterior approach with direct reduction and buttress fixation of articular fragments. Quality of articular reduction is one factor that influences short-term functional outcome.
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