■在治疗胫骨平台骨折(TPF)时,必须恢复关节一致性并保持复位直至愈合。这项研究的主要目的是评估使用同种异体植骨(IBA)增强的可行性,以防止愈合过程中胫骨平台骨折的复位丢失并评估其掺入。
■我们回顾性分析了所有急性,闭合性胫骨平台骨折(SchatzkerII,III,IV)在2010年至2019年期间接受切开复位内固定(ORIF)和同种异体植骨(IBA)治疗,至少随访24个月。我们通过沿胫骨轴绘制一条线和垂直于健康平台的另一条线来评估术后X射线照片,以测量减少和随后的行为。通过放射学分析评估同种异体移植物的整合,非工会,再吸收,或硬化症。我们使用临床放射学Rasmussen系统和西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)来客观化结果。
■包括78个TPF,中位年龄为51.5(40.7-62.2)岁,中位随访时间为66(24-89)个月。两名(2.5%)患者在手术中取得的随访期间出现关节复位(下沉)丢失。76例(94.7%)患者出现整合,两次(2.5%)吸收,和一个(1.3%)硬化症。72名(92.3%)患者在拉斯穆森放射学评分中表现优异和良好的结果,72例(92.3%)患者临床评分优异或良好。术后两年平均WOMAC为15±6.5。
■我们的结果表明,同种异体移植是维持II型减少的佐剂,III,和IVSchatzker胫骨平台骨折。使用它可以预期在随访期间降低的损失率较低。
UNASSIGNED: Restoring joint congruence and maintaining reduction until healing is imperative in treating tibial plateau fractures (TPF). The main objective of this study was to evaluate the feasibility of augmentation with impacted bone
allograft (IBA) to prevent loss of reduction in tibial plateau fractures during healing and to evaluate its incorporation.
UNASSIGNED: We retrospectively analyzed all patients with an acute, closed tibial plateau fracture (Schatzker II, III, IV) treated between 2010 and 2019 with open reduction and internal fixation (ORIF) and impacted bone
allograft (IBA), with a minimum follow-up of 24 months. We evaluated the postoperative radiographs by drawing a line along the tibial axis and another perpendicular to the healthy plateau to measure the reduction and subsequent behavior. The incorporation of the
allograft was evaluated by radiological analysis assessing its integration, non-union, resorption, or sclerosis. We used the clinical-radiological Rasmussen system and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to objectify the outcomes.
UNASSIGNED: 78 TPFs were included, with a median age of 51.5 (40.7-62.2) years and a median follow-up of 66 (24-89) months. Two (2.5 %) patients presented loss of joint reduction (subsidence) during the follow-up regarding the achieved in the surgery. Seventy-six (94.7 %) patients presented integration, two (2.5 %) resorption, and one (1.3 %) sclerosis. Seventy-two (92.3 %) patients presented excellent and good results in the Rasmussen radiological score, and 72 (92.3 %) patients presented excellent or good clinical scores. The mean WOMAC at two years postoperatively was 15 ± 6.5.
UNASSIGNED: Our results demonstrate that
allograft is an adjuvant in maintaining a reduction in type II, III, and IV Schatzker\'s tibial plateau fractures. Low rates of loss of reduction during follow-up can be expected with its use.