合并胫骨平台骨折的膝关节多韧带损伤情况及韧带损伤与胫骨平台骨折分型的相关性分析

颜峰; 喻灿明; 丁志清; 刘利

doi:10.16766/j.cnki.issn.1674-4152.002499

合并胫骨平台骨折的膝关节多韧带损伤情况及韧带损伤与胫骨平台骨折分型的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.002499

台州市中医院骨科，浙江台州 318000

基金项目:

浙江省中医药科技计划项目 2022ZA183

详细信息

通讯作者:
颜峰, E-mail: yf753654@163.com

中图分类号: R683.42 R686.5
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出版历程
- 收稿日期: 2021-12-14
- 网络出版日期: 2022-09-21

Multiple-ligament injury of knee joint combined with tibial plateau fracture and correlation analysis between ligament injury and classification of tibial plateau fracture

Department of Orthopedics, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, Zhejiang 318000, China

摘要

摘要: 目的分析膝关节多韧带损伤合并胫骨平台骨折患者的膝关节多韧带损伤情况以及膝关节多韧带损伤和胫骨平台骨折分型的相关性, 为临床诊治提供参考依据。方法回顾性分析2020年1月-2021年1月台州市中医院诊治的62例膝关节多韧带损伤合并胫骨平台骨折患者, 分析其膝关节多韧带损伤情况, 运用Schatzker分型法、AO分型法、Duparc分型法进行胫骨平台骨折分型, 运用logistic回归分析法分析膝关节多韧带损伤和胫骨平台骨折分型的相关性。结果前交叉韧带损伤(ACL)、后交叉韧带损伤(PCL)、内侧副韧带损伤(MCL)、后外侧角损伤(PLC)、ACL+PCL、ACL+MCL、ACL+PLC、PCL+MCL、PCL+PLC、MCL+PLC的发生率分别为30.65%、8.06%、12.90%、27.42%、1.61%、3.23%、8.06%、1.61%、3.23%、3.23%。Schatzker分型中, Ⅰ~Ⅵ型分别为12、12、4、23、7、4例; AO分型中, B型、C型分别为33、29例; Duparc分型中, 外侧平台骨折、内侧平台骨折、双平台骨折、髁间嵴骨折、后内侧骨折分别为16、15、7、13、11例。Logistic分析结果显示, Schatzker、AO分型与ACL、MCL、PLC存在明显的相关性; Duparc分型与MCL、PLC存在明显的相关性。结论膝关节多韧带损伤合并胫骨平台骨折患者的膝关节多韧带损伤和胫骨平台骨折的Schatzker、AO、Duparc分型之间存在一定的相关性。
- 膝关节多韧带损伤合并胫骨平台骨折 /
- 韧带损伤 /
- 胫骨平台骨折分型 /
- 相关性
Abstract: Objective To analyse the situation of multiple-ligament injury of knee joint combined with tibial plateau fracture and the correlation between multiple-ligament injury of knee joint and the classification of tibial plateau fracture so as to provide reference basis for clinical diagnosis and treatment. Methods Sixty-two patients with knee multiple-ligament injury complicated with tibial plateau fracture diagnosed and treated in the department of orthopaedics and traumatology of Taizhou Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were selected as the research objects.The situation of multiple-ligament injury of knee joint was analysed.Schatzker, AO and Duparc classification methods were used to classify tibial plateau fracture.Logistic regression analysis was used to analyse the correlation between multiple-ligament injury of knee joint and the classification of tibial plateau fracture. Results The incidence of Anterior cruciate ligament injury (ACL), posterior cruciate ligament injury (PCL), medial collateral ligament injury (MCL), posterolateral angle injury (PLC), ACL+PCL, ACL+MCL, ACL+PLC, PCL+MCL, PCL+PLC and MCL+PLC were 30.65%, 8.06%, 12.90%, 27.42%, 1.61%, 3.23%, 8.06%, 1.61%, 3.23% and 3.23%, respectively.In Schatzker's classification, 12, 12, 4, 23, 7 and 4 cases had Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ and Ⅵ classification, respectively.In AO classification, 33 and 29 cases had type B and type C, respectively.In Duparc classification, there were 16, 15, 7, 13 and 11 cases of lateral platform fracture, medial platform fracture, double platform fracture, intercondylar ridge fracture and posterior medial fracture, respectively.Logistic analysis showed that Schatzker and AO typing were significantly correlated with ACL, MCL and PLC.Duparc classification had obvious correlation with MCL and PLC. Conclusion There is a certain correlation between the multiple-ligament injury of knee joint and the Schatzker, AO and Duparc classification of tibial plateau fracture in patients with multiple-ligament injury of knee joint combined with tibial plateau fracture.
- Multiple-ligament injury of knee joint combined with tibial plateau fracture /
- Ligament injury /
- Classification of tibial plateau fractures /
- Relevance

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表 1 62例膝关节多韧带损伤合并胫骨平台骨折患者胫骨平台骨折分型

Table 1. Classification of tibial plateau fracture in 62 patients with multiple ligament injury of knee joint combined with tibial plateau fracture

分型方法	类型		ACL (例)	PCL (例)	MCL (例)	PLC (例)	ACL+PCL (例)	ACL+MCL (例)	ACL+PLC (例)	PCL+MCL (例)	PCL+PLC (例)	MCL+PLC (例)	合计 [例(%)]
Schatzker分型	Ⅰ型		3	1	2	3	0	0	1	0	1	1	12(19.35)
	Ⅱ型		3	1	2	3	1	1	0	0	1	0	12(19.35)
	Ⅲ型		1	0	1	1	0	0	1	0	0	0	4(6.45)
	Ⅳ型		8	2	1	7	0	1	2	1	0	1	23(37.10)
	Ⅴ型		2	1	1	2	0	0	1	0	0	0	7(11.29)
	Ⅵ型		2	0	1	1	0	0	0	0	0	0	4(6.45)
AO分型	B型	B1型	5	1	2	3	0	1	1	0	1	0	14(22.58)
		B2型	4	0	1	4	0	0	1	0	0	0	10(16.13)
		B3型	3	1	1	2	0	0	1	0	0	1	9(14.52)
	C型	C1型	4	2	3	5	1	1	2	1	1	0	20(32.26)
		C2型	3	1	1	3	0	0	0	0	0	0	8(12.90)
		C3型	0	0	0	0	0	0	0	0	0	1	1(1.61)
Duparc分型	外侧平台骨折		3	2	2	3	1	1	2	0	1	1	16(25.81)
	内侧平台骨折		5	1	2	4	0	1	1	0	0	1	15(24.19)
	双平台骨折		2	1	1	2	0	0	0	1	0	0	7(11.29)
	髁间嵴骨折		6	0	1	5	0	0	1	0	0	0	13(20.97)
	后内侧骨折		3	1	2	3	0	0	1	0	1	0	11(17.74)

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表 2 膝关节多韧带损伤和胫骨平台骨折分型的相关性分析

Table 2. Correlation Analysis between multiple ligament injury of knee joint and classification of tibial plateau fracture

分型方法	ACL			PCL			MCL			PLC
分型方法	P值	OR值	95% CI	P值	OR值	95% CI	P值	OR值	95% CI	P值	OR值	95% CI
Schatzker分型	0.046	2.681	1.197~4.933	0.623	0.854	0.473~1.561	0.035	2.931	1.356~3.782	0.026	3.124	1.204~6.725
AO分型	0.032	3.004	1.571~7.373	0.582	0.795	0.247~1.146	0.020	3.742	1.436~5.234	0.011	4.668	1.582~10.563
Duparc分型	0.702	0.925	0.558~1.146	0.673	0.788	0.379~1.057	0.007	7.236	1.682~7.237	＜0.001	6.622	1.563~7.934

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