胫骨前内侧撞击骨折在膝关节后外复合体损伤中的发生率及其临床特点  

Analysis of the incidence and clinical characteristics of anteromedial impingement fracture of tibial plateau in patients with posterolateral knee complex injury

作　　者：张军[1] 龙果 李路 ZHANG Jun;LONG Guo;LI Lu(Department of Sport Medicine,The First People’s Hospital of Kashi Prefecture,Kashi,Xinjiang,844000,China)

机构地区：[1]喀什地区第一人民医院运动医学科,新疆844000 [2]喀什地区巴楚县人民医院,新疆843800

出　　处：《中国骨与关节杂志》2023年第2期131-134,共4页Chinese Journal of Bone and Joint

摘　　要：目的胫骨前内侧撞击骨折在膝关节后外复合体损伤中的发生率并分析其临床特点。方法收集2018年1月至2021年1月在喀什地区第一人民医院运动医学科收治的153例膝关节后外复合体损伤患者。根据影像学资料统计胫骨平台前内侧撞击骨折的发生率。根据有无胫骨前内侧撞击骨折将患者分为两组,胫骨前内侧撞击骨折患者作为观察组,非胫骨前内侧撞击骨折患者作为对照组,比较两组患者不稳定性程度。再根据骨折块大小将胫骨前内侧撞击骨折组分为边缘型骨折组(骨折块横径<5 mm)和压缩型骨折组(骨折块横径≥5 mm),比较两组患者的不稳定性程度及合并损伤情况。结果153例膝关节后外复合体损伤患者中观察组10例(6.54%),对照组143例(93.46%)。相比对照组,观察组患者后向不稳定性更严重(P=0.016)。与边缘型骨折组相比,压缩型骨折组患者后向不稳定更为严重(P=0.018)。压缩型骨折组合并腓总神经损伤的发生率高于边缘型骨折组(P=0.035)。结论虽膝关节后外复合体损伤中胫骨前内侧撞击骨折患者的发生率低,但其后向不稳定性更严重,其中压缩型骨折患者的后向不稳定型及血管神经损伤更为严重。临床上应重视对膝关节后外复合体损伤合并胫骨平台前内侧撞击骨折患者的后向稳定性检查及血管神经情况检查。Objective To analyze the incidence and clinical characteristics of anteromedial impingement fracture of tibial plateau in patients with posterolateral knee complex injury.Methods A series of 153 patients with posterolateral knee complex injury who were admitted to the Department of Sport Medicine of the First People’s Hospital of Kashi from January 2018 to January 2021 was enrolled.The incidence of anteromedial impingement fracture of the tibial plateau was revealed by imaging data.All patients were divided into two groups according to the presence or absence of anteromedial tibial impingement fracture.Patients with anteromedial tibial impingement fracture served as the observation group,and patients without anteromedial tibial impingement fracture served as the control group.The degree of instability of the two groups was compared.According to the size of the fracture fragment,the anteromedial impingement fracture group of the tibia was divided into a marginal fracture group(fragment transverse diameter<5 mm)and a compression fracture group(fragment transverse diameter≥5 mm);the degree of instability and the combined injury of the two groups were compared.Results Among the 153 cases of knee joint injury,10 cases(6.54%)were in the observation group and 143 cases(93.46%)in the control group.Compared with the control group,the observation group had severer backward instability(P=0.016).Compared with the marginal fracture group,the compression fracture group had severer backward instability(P=0.018).In addition,the incidence of common peroneal nerve injury in the compression fracture group was higher than that in the marginal fracture group(P=0.035).Conclusions Although the incidence of anteromedial impingement fracture in patients with posterolateral knee complex injury is low,the posterior instability is severer with vascular and nerve damage.Clinically,attention should be paid to the examination of the posterior stability,vascular and nerve conditions in patients with posterolateral knee complex injury combin

关 键 词：胫骨 骨折 膝关节 血管系统损伤 周围神经损伤 

分 类 号：R683.4[医药卫生—骨科学]