| 关节内矢状面复位对胫骨平台骨折治疗的指导意义 |
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投稿时间：2024-06-30
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| 作者 | Author | 单位 | Address | E-Mail |
| 张家凡 |
ZHANG Jia-fan |
首都医科大学附属北京潞河医院, 北京 101149 |
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
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| 龙安华 |
LONG An-hua |
首都医科大学附属北京潞河医院, 北京 101149 |
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
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| 韩大成 |
HAN Da-cheng |
首都医科大学附属北京潞河医院, 北京 101149 |
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
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| 贾梓超 |
JIA Zi-chao |
应急管理部应急总医院, 北京 100020 |
Emergency General Hospital, Beijing 100020, China |
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| 张亚奎 |
ZHANG Ya-kui |
首都医科大学附属北京潞河医院, 北京 101149 |
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
zhangyakui@vip.sina.com |
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| 期刊信息：《中国骨伤》2025年，第38卷，第1期，第100-104页 |
| DOI：10.12200/j.issn.1003-0034.20240268 |
| 基金项目: |
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| 中文摘要:胫骨平台骨折是累及胫骨近端关节面的骨折，其损伤机制复杂、骨折形态不一，且多伴有不同程度的软组织损伤，诊断治疗难度大。近年来的研究热点集中于解决胫骨平台后侧柱的复位与固定，因为临床上发现胫骨平台骨折术后残留矢状面的复位不足或复位丢失导致膝关节功能障碍。胫骨平台后倾角是描述胫骨矢状面力线的重要参数。在自然状态下，胫骨平台后倾角(posterior tibial slope，PTS)发生改变累及前交叉韧带(anterior cruciate ligament，ACL)、后交叉韧带(posterior cruciate ligament，PCL)等膝关节周围软组织，影响膝关节稳定性。在全膝关节置换(total knee arthroplasty，TKA)中，选择合适的PTS能有效增加假体存留率，提高屈伸膝效能，有利于膝关节稳定。在创伤骨科领域，纠正矢状面畸形同样重要，需遵循“逆损伤机制”原则。定量评价胫骨平台骨折术后的矢状面复位情况，探讨矢状面复位对术后远期效果及并发症的影响，目前认识尚浅，有待进一步的临床和生物力学研究。 |
| 【关键词】胫骨平台骨折 矢状面畸形 胫骨平台后倾角 前交叉韧带 生物力学 |
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| Guiding significance of intra-articular sagittal reduction in the treatment of tibial plateau fractures |
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| ABSTRACT Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia,and its injury mechanism is complex,the fracture morphology is different,and it is often accompanied by different degrees of soft tissue injury,which is difficult to diagnose and treat. In recent years,the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau,because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia. In the natural state,the posterior tibial slope(PTS) is altered to involve the soft tissues around the knee joint such as anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL),which affects the stability of the knee joint. In total knee arthroplasty(TKA),choosing the appropriate PTS can effectively increase the prosthesis survival rate,improve the flexion and extension knee efficacy,which is beneficial to knee joint stability. In the field of orthopedic trauma,correction of sagittal deformity is equally important,following the principle of "reverse mechanism of injury". Quantitative evaluation of postoperative sagittal realignment of tibial plateau fractures and investigation of the effect of sagittal realignment on long-term outcomes and complications are still poorly understood and require further clinical and biomechanical studies. |
| KEY WORDS Tibial plateau fracture Sagittal deformity Posterior tibial slope Anterior cruciate ligament Biomechanics |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张家凡,龙安华,韩大成,贾梓超,张亚奎.关节内矢状面复位对胫骨平台骨折治疗的指导意义[J].中国骨伤,2025,38(1):100~104 |
| 英文格式: | ZHANG Jia-fan,LONG An-hua,HAN Da-cheng,JIA Zi-chao,ZHANG Ya-kui.Guiding significance of intra-articular sagittal reduction in the treatment of tibial plateau fractures[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(1):100~104 |
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