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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 476 -481. doi: 10.3877/cma.j.issn.1674-134X.2021.04.012

综述

胫骨平台后外侧髁骨折的治疗及评价进展
黄廷杰1, 贺毅1, 黄建荣1,()   
  1. 1. 510700 广州医科大学附属第五医院
  • 收稿日期:2021-03-09 出版日期:2021-09-29
  • 通信作者: 黄建荣
  • 基金资助:
    广东省自然科学基金项目(2017A030313606)

Treatment and evaluation of posterolateral column fracture of tibial platea

Tingjie Huang1, Yi He1, Jianrong Huang1,()   

  1. 1. Department of Orthopaedic trauma, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, China
  • Received:2021-03-09 Published:2021-09-29
  • Corresponding author: Jianrong Huang
引用本文:

黄廷杰, 贺毅, 黄建荣. 胫骨平台后外侧髁骨折的治疗及评价进展[J]. 中华关节外科杂志(电子版), 2021, 15(04): 476-481.

Tingjie Huang, Yi He, Jianrong Huang. Treatment and evaluation of posterolateral column fracture of tibial platea[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(04): 476-481.

胫骨平台后外侧髁骨折(PLCF)是指外侧胫骨平台后1/3的骨折,占所有胫骨平台骨折的15%~44.2%。胫骨平台骨折的分型方法日新月异,但三柱理论仍然被最常用于指导胫骨平台后外侧柱骨折的诊断和治疗;常用治疗胫骨平台后外侧髁骨折的手术入路包括后正中入路、腓骨颈截骨的后外侧入路、经膝关节后外侧入路等,治疗方法除常规的钢板螺钉内固定外,还有环形外固定架、球囊扩张、关节镜辅助的微创治疗方法等;对于胫骨平台后外侧髁骨折术后评估除了常见的美国特种外科医院(HSS)膝关节评分、Rasmussen影像学评分外还增加了对胫骨平台内翻角(TP-TSA)以及后倾角(PSA)等角度的测量。本文就胫骨平台后外侧髁骨折的治疗与术后影像学及其功能评价等方面作一综述。

Posterolateral column fracture of the tibial plateau (PLCF) refers to the fracture of the posterior third of the lateral tibial plateau, accounting for 15% to 44.2% of all tibial plateau fractures.The classification methods of tibial plateau fractures are changing with each passing day, but the three-column theory is still most commonly used to guide the diagnosis and treatment of tibial plateau posterolateral column fractures; the commonly used surgical approaches for the treatment of tibial plateau posterolateral condylar fractures include posteromedial approach, posterolateral approach of fibular neck osteotomy, posterolateral approach of knee joint, etc. In addition to conventional plate and screw internal fixation, there are circular external fixator, balloon tibioplasty, arthroscopic assisted minimally invasive treatment. For the postoperative evaluation of posterolateral condylar fracture of tibial plateau, in addition to the common Hospital for Special Surgery(HSS) knee joint score and Rasmussen imaging score, the tibial plateau tibial shaft angle (TP-TSA) and posterior slope angle (PSA) are also increased. This article reviewed the treatment, postoperative imaging and functional evaluation of posterolateral tibial plateau fractures.

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