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中华损伤与修复杂志(电子版)

中华损伤与修复杂志(电子版) ›› 2022, Vol. 17 ›› Issue (02) : 176 -181. doi: 10.3877/cma.j.issn.1673-9450.2022.02.017

综述

胫骨平台后外侧骨折块的固定与治疗近状
丁尧坤1, 宗群川1, 李长帅1, 王涛1,†()   
  1. 1. 810000　西宁，青海大学附属医院创伤骨科
  • 收稿日期:2022-01-18 出版日期:2022-04-01
  • 通信作者: 王涛

Fixation and treatment of posterolateral tibial plateau fracture

Yaokun Ding1, Qunchuan Zong1, Changshuai Li1, Tao Wang1,†()   

  1. 1. Derpartment of Traumatic Orthopedics, Affiliated Hospital of Qinghai University, Xining 810000, China
  • Received:2022-01-18 Published:2022-04-01
  • Corresponding author: Tao Wang
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丁尧坤, 宗群川, 李长帅, 王涛. 胫骨平台后外侧骨折块的固定与治疗近状[J]. 中华损伤与修复杂志(电子版), 2022, 17(02): 176-181.

Yaokun Ding, Qunchuan Zong, Changshuai Li, Tao Wang. Fixation and treatment of posterolateral tibial plateau fracture[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(02): 176-181.

胫骨平台后外侧骨折属于关节内骨折，对膝关节功能有显著影响。胫骨平台后柱骨折被认为是膝关节功能不良的推动因素。针对胫骨平台后外侧骨折除了选择合适的手术入路进行骨折的显露，骨折块的支撑也是影响治疗效果的重要因素。加之胫骨近端后部形态特征和胫骨平台后外侧骨折局部解剖关系复杂，对手术入路方式的选择，存在争议。术前对软组织损伤的了解有助于术者全面地描述整体损伤，通过骨折形态与损伤机制之间关系的分型，可以强化临床医师对胫骨平台后外侧骨折的全面理解，有助于术者选择合适的手术入路。在处理胫骨平台后外侧骨折时，不仅要考虑骨折块的暴露与固定，还要关注骨折形态、损伤机制、软组织损伤。近些年来随着新式内固定装置的研发，对术者优化胫骨平台后外侧骨折手术入路具有辅助作用。

关键词: 胫骨平台后外侧骨折, 手术入路, 软组织损伤, 损伤机制, 骨折形态, 内固定

The posterolateral tibial plateau fracture belongs to intra-articular fracture, which has a significant impact on the function of knee joint. Tibial plateau posterior column fracture is considered to be a driving factor of knee dysfunction. For the posterolateral tibial plateau fracture, in addition to selecting the appropriate surgical approach for the exposure of the fracture, the support of the fracture block is also an important factor affecting the treatment effect. In addition, the relationship between the morphological characteristics of the proximal posterior tibia and the local anatomy of the posterolateral tibial plateau fracture is complex, and the choice of surgical approach is controversial. The preoperative understanding of soft tissue injury is helpful for the operator to comprehensively describe the overall injury. The classification of the relationship between fracture morphology and injury mechanism can strengthen the clinician′s comprehensive understanding of the posterolateral tibial plateau fracture and help the operator to choose an appropriate surgical approach. When dealing with the posterolateral tibial plateau fracture, we should not only consider the exposure and fixation of the fracture block, but also pay attention to the fracture morphology, injury mechanism and soft tissue injury. In recent years, with the development of new internal fixation devices, it plays an auxiliary role in optimizing the surgical approach of posterolateral tibial plateau fracture.

Key words: Posterolateral tibial plateau fracture, Surgical approach, Soft -tissue injury, Damage mechanism, Fracture morphology, Internal fixation
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