胫骨平台外侧骨折形态与半月板损伤的相关性

doi:10.3969/j.issn.1671-167X.2016.02.017

北京大学学报(医学版) ›› 2016, Vol. 48 ›› Issue (2): 274-278. doi: 10.3969/j.issn.1671-167X.2016.02.017

胫骨平台外侧骨折形态与半月板损伤的相关性

白露1，周雯2，张文涛1△，黄伟1，尤田1，陈鹏1，张洪雷1

（北京大学深圳医院1. 运动医学科,2. 放射科, 广东深圳518036）

出版日期:2016-04-18 发布日期:2016-04-18
通讯作者: 张文涛 E-mail:zhangwt2007@sina.cn
基金资助:
深圳市科技计划项目（医疗卫生类）资助（201303042）

Correlation between morphogical factor of lateral plateau fracture and meniscus injury

BAI Lu1, ZHOU Wen2, ZHANG Wen-tao1△, HUANG Wei1, YOU Tian1 ,CHEN Peng1,ZHANG Hong-lei1

（1. Department of Sports Medicine, 2. Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong， China)

Online:2016-04-18 Published:2016-04-18
Contact: ZHANG Wen-tao1 E-mail:zhangwt2007@sina.cn
Supported by:
Supported by Shenzhen Science and Technology Project (Medical and Health, 201303042)

摘要/Abstract

摘要：

目的：探究胫骨外侧平台骨折形态特点与半月板损伤的关系。方法：纳入2011年7月至2015年7月影像学资料完整的单纯胫骨外侧平台骨折患者共计79例，其中男性患者65例，女性14例，平均年龄(34.3±7.2)岁（22~61岁）。按照Schatzker分型： Ⅰ型21例，Ⅱ型41例，Ⅲ型17例。所有患者均在就诊时拍摄膝关节正、侧位片，并行磁共振(magnetic resonance imaging，MRI)检查。通过阅片确定患者半月板损伤及程度，并在MRI片上三维测量外侧平台骨折宽度（lateral fragment width, LFW）、外侧平台塌陷程度（lateral plateau depression, LPD）、外侧骨折片冠状面倾斜角（coronal angulation of lateral fragment, CALF）和胫骨平台增宽距离（tibial plateau widening, TPW），分析有、无半月板损伤病例的上述测量数据，进行组间对比。结果：本组病例MRI检出半月板损伤者26例（32.9%）,其中Schatzker Ⅰ型3例， Schatzker Ⅱ型16例，Schatzker Ⅲ型7例。无半月板损伤组平均LFW（22.0±2.8） mm，半月板损伤组为（21.3±3.3） mm，组间比较差异无统计学意义（t=-1.008，P=0.317）；无半月板损伤组平均LPD（5.4±2.8） mm，半月板损伤组为（8.7±2.8） mm，组间比较差异有统计学意义（t=4.98，P=0.001）;无半月板损伤组平均外侧CALF 9.1°±6.1°，半月板损伤组为 10.6°±7.1°，组间对比差异无统计学意义（t=0.38，P=0.831）;无半月板损伤组平均TPW为（3.0±1.1） mm，半月板损伤组为（4.8±1.7） mm,组间对比差异有统计学意义（t=5.216，P=0.001）。结论：在胫骨外侧平台骨折中，其伴发半月板损伤概率随LPD和TPW而增加，而LFW和CALF与半月板损伤无明显相关性。

关键词: 胫骨骨折, 关节内骨折, 半月板, 胫骨

Abstract:

Objective：To analyze morphological character of lateral tibial plateau fracture fragment, and its correlation to the presence of a meniscus injury in tibial plateau fractures. Methods: A total of 79 consecutive patients of the simple lateral tibial plateau fractures from July 2011 to July 2015 were inclu-ded in this study, with 65 males and 14 females with an average age of (34.3±7.2) years and 22-61 years. According to Schatzker classification, 21 cases were of Type Ⅰ, 41 cases Type Ⅱ, and 17 cases Type Ⅲ. The characteristics of lateral tibial plateau fractures were evaluated by plain X-ray and magnetic resonance imaging (MRI). The type and severity of meniscus injury were diagnosed by MRI scan. Three-dimensional measurements of the lateral fragment width (LFW), the lateral plateau depression (LPD), the coronal angulation of lateral fragment (CALF), and tibial plateau widening (TPW) were measured with Picture Archiving and Communication Systems(PACS) software. The patients with and without meniscus injuries were divided into different groups and analyzed respectively. Comparison of the above measurements between the two groups was analyzed by independent t test. Results: In all the 79 lateral tibial plateau fracture patients, 26 cases (32.9%) of meniscus injuries were detected by MRI. Among all the meniscus injury cases, 3 were of Schatzker Ⅰ, 16 Schatzker Ⅱ, and 7 Schatzker Ⅲ. In meniscus intact group, the average LFW was (22.0±2.8) mm while in meniscus injury group it was (21.3±3.3) mm (t=-1.008, P=0.317).The average LPD of non meniscus injury group was (5.4±2.8) mm, while in meniscus injury group was (8.7±2.8) mm (t=4.98, P=0.001). The average CALF of the two groups were 9.1°±6.1°and 10.6°± 7.1°, and there was no significant dif-ference between the two groups (t=0.38, P=0.831). The average TPW was (3.0± 1.1) mm, and (4.8±1.7) mm of the two groups. There were significant differences between the two groups (t=5.216, P=0.001).Conclusion: There was no obvious correlation between the LFD and meniscus injury. The CALF of lateral tibial plateau fracture had no significant correlation with meniscus injury either. The degree of LPD and TPW may indicate injury of the meniscus in tibial plateau fractures.

Key words: Tibial fractures, Intra-articular fractures, Menisci, tibial

中图分类号:

R683.42

白露，周雯，张文涛，黄伟，尤田，陈鹏，张洪雷. 胫骨平台外侧骨折形态与半月板损伤的相关性[J]. 北京大学学报(医学版), 2016, 48(2): 274-278.

BAI Lu, ZHOU Wen, ZHANG Wen-tao, HUANG Wei1, YOU Tian,CHEN Peng,ZHANG Hong-lei. Correlation between morphogical factor of lateral plateau fracture and meniscus injury[J]. Journal of Peking University(Health Sciences), 2016, 48(2): 274-278.

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胫骨平台外侧骨折形态与半月板损伤的相关性

Correlation between morphogical factor of lateral plateau fracture and meniscus injury

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