胫骨平台后外侧骨折的研究进展

Research progress of posterolateral fracture of tibial plateau

胫骨平台位于胫骨近端,由关节软骨包绕,是膝关节与股骨下端接触的关节面。胫骨平台后外侧骨折属于人体膝关节的关节内骨折,在全身骨折中其占比较低。胫骨平台后外侧在下肢承重及膝关节活动中起着至关重要的作用,所以胫骨平台后外侧骨折一直是创伤骨科医生关注的重点。胫骨平台后外侧周围包绕着较多的神经和血管组织,解剖结构复杂,导致术中暴露骨折部位困难且术中操作空间有限;若未获得规范的诊疗可能严重影响患者膝关节的功能恢复,造成膝关节屈曲位不稳定、骨折畸形愈合、创伤性膝关节炎等严重并发症。在治疗此类骨折时,充分掌握相关解剖结构和治疗方法至关重要。临床上应根据骨折类型、周围软组织包绕情况选择正确的手术入路,同时需要控制手术时的副损伤。近年来随着医疗技术的不断发展,胫骨平台后外侧骨折的诊断及手术治疗方法逐渐得到完善,从而能够有效促进患者膝关节功能的恢复,减少并发症的发生。在这篇文章中,我们将参考近几年来的最新研究进展重点介绍胫骨平台后外侧骨折的诊断方法、损伤机制及可暴露胫骨平台后外侧骨折的手术入路,旨在提高临床上对胫骨平台后外侧骨折的认识,为下一步的基础研究及相关临床治疗提供参考。

The tibial plateau is located near the tibia and surrounded by articular cartilage.It is the articular surface where the knee joint contacts the lower end of the femur.The posterolateral fracture of tibial plateau belongs to the intra-articular fracture of human knee joint,which accounts for a relatively low proportion in the total fracture.The posterolateral tibial plateau plays an important role in the bearing of lower limbs and knee joint activity,so the posterolateral tibial plateau fracture has always been the focus of orthopaedic trauma surgeons.The posterior lateral tibial plateau is surrounded by more nerve and vascular tissues,and the anatomical structure is complex,resulting in intraoperative exposure of the fracture site is difficult and intraoperative space is limited.Failure to obtain standard diagnosis and treatment may seriously affect the functional recovery of patients with knee joint,resulting in unstable knee flexion,fracture malunion,traumatic knee arthritis and other serious complications.In the treatment of such fractures,it is important to fully understand the relevant anatomy and treatment.Clinically,the correct surgical approach should be selected according to the fracture type and surrounding soft tissue wrapping,and the collateral injury should be controlled.In recent years,with the continuous development of medical technology,the diagnosis and surgical treatment of posterolateral tibial plateau fracture have been gradually improved,which can effectively promote the recovery of patients’knee function and reduce the occurrence of complications.In this paper,we will refer to the latest research progress in recent years to focus on the diagnosis of posterolateral tibial plateau fracture,the injury mechanism and the surgical approach that can expose posterolateral tibial plateau fracture,in order to improve the clinical understanding of posterolateral tibial plateau fracture and provide reference for the next step of basic research and related clinical treatment.