PDF(Pubmed)
Abstract：
BACKGROUND The objective of this investigation was to assess the effectiveness of using T-shaped steel plates through the anterior lateral approach and Gerdy\'s tubercle osteotomy for treating posterior lateral tibial plateau fractures. MATERIAL AND METHODS A retrospective analysis was conducted on clinical data from 20 patients, aged on average 53.9±10.36 years, who were admitted for tibial plateau fractures involving the posterior lateral condyle between January 2019 and October 2022. The fixation and reduction of the posterior lateral bone block were performed using the anterior lateral approach combined with Gerdy\'s tubercle osteotomy to address the posterior lateral tibial plateau fracture. Post-surgery assessment was conducted using the Hospital for Special Surgery (HSS) knee combined score. RESULTS During the 12-24 (14.2±1.7) month postoperative period, we conducted 20 surgeries. Within 9 to 12 weeks, fracture healing transpired without any complications such as incision infection, nerve injury, or fracture displacement being detected. Assessment of knee joint function at the final follow-up was conducted using the HSS knee combined score, with results indicating 16 cases rated as excellent, 3 cases as good, and 1 case as fair. CONCLUSIONS In tibial plateau fractures impacting the posterior lateral condyle, the anterior lateral approach, combined with Gerdy\'s tubercle osteotomy, allows for direct exposure and manipulation of the posterior lateral bone block fracture. Using a T-shaped support plate and a lateral locking plate provides a reliable method for fracture fixation, aiding in convenient surgical positioning and intraoperative fluoroscopy. The treatment approach effectively manages fractures located on the posterior lateral aspect of the tibial plateau.
摘要：
背景这项研究的目的是评估通过前外侧入路和Gerdy结节截骨术使用T形钢板治疗胫骨平台后外侧骨折的有效性。材料与方法回顾性分析20例患者的临床资料,平均年龄53.9±10.36岁，患者于2019年1月至2022年10月期间因涉及后外侧髁的胫骨平台骨折入院.采用前外侧入路联合Gerdy’s结节截骨术治疗胫骨平台后外侧骨折,对后外侧骨块进行固定复位。术后评估采用特殊外科医院（HSS）膝关节综合评分进行。结果在术后12-24（14.2±1.7）个月期间，我们进行了20次手术。在9到12周内,骨折愈合无任何并发症，如切口感染，神经损伤,或检测到裂缝位移。最终随访时采用HSS膝关节联合评分对膝关节功能进行评估,结果表明16例被评为优秀，3例一样好，和1个案例一样公平。结论在影响后外侧髁的胫骨平台骨折中,前外侧入路,结合Gerdy结节截骨术，允许直接暴露和操作后外侧骨块骨折。使用T形支撑板和侧向锁定板提供了一种可靠的骨折固定方法，帮助方便的手术定位和术中透视。该治疗方法可有效治疗位于胫骨平台后外侧的骨折。
