"反Schatzker Ⅳ型"胫骨平台骨折一例报告
An uncommon tibial plateau fracture:reverse Schatzker type Ⅳ
徐晨阳 1徐静磊 1畅宁 1马献忠 1徐斌2
作者信息
- 1. 河南省洛阳正骨医院郑州院区骨盆髋臼创伤外科,郑州 450000
- 2. 河南省信阳市息县人民医院骨科,信阳 464300
- 折叠
摘要
报告1例罕见的脱位型胫骨平台骨折的病例.患者因车祸致胫骨平台闭合性骨折,其骨折类型不符合任何一种现有的胫骨平台骨折分型.术前影像学检查提示外侧平台骨折伴膝关节内侧脱位和内侧半月板在骨折端嵌顿.推测其损伤机制可能为膝关节中立位或过伸位时胫骨相对股骨侧发生外翻和内旋.患者膝关节正位X线片显示骨折线通过外侧平台,膝关节内侧脱位,与经典的屈膝内翻、内旋损伤机制造成的Schatzker Ⅳ型骨折脱位影像互为镜像,因此将其命名为"反Schatzker Ⅳ型"胫骨平台骨折.于伤后第8天给予切开复位内固定术,术后应用膝关节铰链式支具固定.术后6个月骨折愈合,膝关节伸屈活动度125°-5°.
Abstract
This report presents a rare case of a dislocated tibial plateau fracture.The patient sustained a closed fracture of the tibial plateau following a traffic accident,exhibiting a fracture pattern not fitting into any existing classification of tibial plateau fractures.Preoperative imaging revealed a lateral plateau fracture with medial dislocation of the knee joint and entrapment of the medial meniscus within the gap.The injury mechanism is hypothesized to involve external and internal rotation of the tibia relative to the femur,occurring during neutral or hyperextended positions of the knee joint.The patient's knee joint X-ray showed a frac-ture line passing through the lateral plateau,accompanied by medial dislocation of the knee joint,which mirrored the imaging of a Schatzker Type Ⅳ fracture dislocation caused by the classic mechanism of flexion varus and internal rotation.Hence,it was desig-nated as a"reverse Schatzker type Ⅳ"tibial plateau fracture.Open reduction and internal fixation were performed on the 8th day post-injury,followed by knee joint stabilization with a hinge brace and guided functional exercises.Six months post-surgery,reeval-uation indicated complete fracture healing and a knee flexion-extension range of 125°-5°.
关键词
胫骨骨折/骨折固定术,内/病例报告Key words
Tibial fractures/Fracture fixation,internal/Case reports引用本文复制引用
出版年
2024
NETL
NSTL
万方数据