前交叉韧带损伤形式与胫骨平台后侧骨损伤的相关性分析  

Correlation analysis between anterior cruciate ligament injury and posterior tibial plateau injury

作　　者：劳子胤 张炳耀 冯青 Lao Ziyin;Zhang Bingyao;Feng Qing(The Graduate School of Chengde Medical University,Chengde 067000,China;The Fourth Department of Orthopedics,Cangzhou people's hospital,Cangzhou 061000,China)

机构地区：[1]承德医学院研究生学院,067000 [2]沧州市人民医院骨四科,061000

出　　处：《中华老年骨科与康复电子杂志》2021年第2期73-78,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：河北省科技计划项目(162777235)。

摘　　要：目的分析前交叉韧带(ACL)损伤、断裂及撕脱骨折与胫骨平台(TP)后侧骨损伤的关系。方法回顾性检索沧州市人民医院2017年6月至2019年3月收治的膝关节MRI表现为ACL损伤、断裂及撕脱骨折的患者219例,平均年龄(41±14)岁,男性122例(55.71%),女性97例(44.29%),分析所有患者的膝关节MRI影像学资料,记录胫骨平台后侧骨损伤情况与ACL损伤情况。本研究胫骨平台后侧骨损伤分为三种形式,分别为无损伤、骨挫伤与骨折。ACL损伤情况分为三种,分别为ACL损伤组、断裂组及撕脱骨折组。最终入选病例ACL损伤组147例,ACL断裂组48例,ACL撕脱骨折组24例。比较三组患者的胫骨平台后侧骨损伤发生情况,分析患者ACL损伤与胫骨平台后侧骨损伤之间的关系。结果 219例ACL损伤患者中,131例出现胫骨平台后侧骨挫伤或(和)胫骨平台后侧骨折,其中后侧骨折33例(25.2%),后侧骨挫伤98例(74.8%)。胫骨平台后侧骨损伤发生率由高至低依次为ACL撕脱骨折组(91.6%),ACL断裂组(85.4%)和ACL损伤组(46.2%)。ACL损伤程度与胫骨平台后侧骨损伤等级之间存在线性趋势(χ^(2)=0.433,P<0.05)。结论随着ACL损伤程度的加重,胫骨平台后侧骨损伤发生的概率增大,诊治该类患者应行术前MRI和CT检查,避免漏诊漏治。Objective To analyse the relationship between the anterior cruciate ligament(injury,rupture, and avulsion fracture) and the posterior bone injury of the tibial plateau. Methods A retrospective search of 219 patients with ACL injuries, ruptures, and avulsion fractures on knee MRI were admitted to our hospital from June 2017 to March 2019, with an average age of(41±14) years, 122 males(55.71%), females in 97 cases(44.29%), the knee MRI imaging data of all patients were analyzed, and the posterior tibial plateau bone injury and ACL injury were recorded. In this study, there are three types of bone injury on the posterior of the tibial plateau: normal, bone contusion and fracture. ACL injuries are divided into three group,namely ACL injury group, fracture group and avulsion fracture group. Finally, 147 cases were in the ACL injury group, 48 cases were in the ACL rupture group, and 24 cases were in the ACL avulsion fracture group.The occurrence of bone injury on the posterior tibial plateau of the three groups was compared, and the relationship between the ACL injury and the posterior tibial plateau bone injury of patients was analyzed. Results Among the 219 ACL injuries, 131 had posterior tibial plateau bone injury, of which 33(25.2%) were fractures and 98(74.8%) were posterior bone contusions. The incidence of bone injury on the posterior side of the tibial plateau was followed by ACL avulsion fracture group(91.6%), ACL rupture group(85.4%) and ACL injury group(46.2%). There is a linear trend between the degree of ACL damage and the grade of bone damage on the posterior side of the tibial plateau(χ^(2)=0.433, P<0.05). Conclusions With the severity of ACL injury, the probability of bone injury on the posterior side of the tibial plateau increases. Preoperative MRI and CT examinations should be performed to diagnose and treat such patients to avoid missed diagnosis and treatment.

关 键 词：前交叉韧带损伤 胫骨 相关性分析 

分 类 号：R687.3[医药卫生—骨科学]