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[Analysis of the characteristics and clinical diagnosis and treatment of avulsion fracture of the lateral edge of tibial plateau].
Zhongguo Gu Shang 2018; 31(2):155-159ZG

Abstract

OBJECTIVE

To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries.

METHODS

From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old. Among them, there were 20 cases of anterior cruciate ligament rupture (ACL rupture) involving the anterior cruciate ligament tibial eminence avulsion fracture included, 3 cases of posterior cruciate ligament rupture (PCL rupture), 1 case of ACL rupture combined with PCL rupture, 3 cases of medial collateral ligament tear, and 2 cases combined fractures of tibial plateau (1 case of the medial platform fractures and 1 cases of lateral fracture). All the patients were confirmed by X-rays, CT and MRI. The procedures were performed at 5 to 14 days after the injury(means 7 days). Lysholm scores were used to assess the knee function before and after the operation.

RESULTS

The operation time was 40 to 125 minutes (means 85 minutes), the intraoperative blood loss was 10 to 30 ml (means 15 ml). All paients were followed up for 12 to 18 months(means 14 months). The Lysholm scores were significantly improved from preoperative 52.0±4.2 to 91.9±1.4(t=-49.24, P<0.05). The results of drawer test, Lachman test and lateral stress test were negative in all 29 cases, all the fractures of 29 patients were bony union.

CONCLUSIONS

The avulsion fracture of the lateral tibial plateau suggests that there are knee joint static and stable structures(joint ligament, joint capsule, meniscus, et al) and even intra articular fractures. Therefore, besides conventional imaging examinations, arthroscopic exploration was also necessary to avoid misdiagnose and provide comprehensive assessments and treatment. This can create favorable conditions for the knee joint function restore maximum.

Authors+Show Affiliations

Department of Orthopaedics, Ningbo Fourth Hospital, Xiangshan 315700, Zhejiang, China; xspjp2012@163.com.Department of Orthopaedics, Ningbo Fourth Hospital, Xiangshan 315700, Zhejiang, China.Department of Orthopaedics, Ningbo Fourth Hospital, Xiangshan 315700, Zhejiang, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

29536687

Citation

Pan, Jia-Ping, et al. "[Analysis of the Characteristics and Clinical Diagnosis and Treatment of Avulsion Fracture of the Lateral Edge of Tibial Plateau]." Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology, vol. 31, no. 2, 2018, pp. 155-159.
Pan JP, Wang XC, Huang MH. [Analysis of the characteristics and clinical diagnosis and treatment of avulsion fracture of the lateral edge of tibial plateau]. Zhongguo Gu Shang. 2018;31(2):155-159.
Pan, J. P., Wang, X. C., & Huang, M. H. (2018). [Analysis of the characteristics and clinical diagnosis and treatment of avulsion fracture of the lateral edge of tibial plateau]. Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology, 31(2), pp. 155-159. doi:10.3969/j.issn.1003-0034.2018.02.012.
Pan JP, Wang XC, Huang MH. [Analysis of the Characteristics and Clinical Diagnosis and Treatment of Avulsion Fracture of the Lateral Edge of Tibial Plateau]. Zhongguo Gu Shang. 2018 Feb 25;31(2):155-159. PubMed PMID: 29536687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Analysis of the characteristics and clinical diagnosis and treatment of avulsion fracture of the lateral edge of tibial plateau]. AU - Pan,Jia-Ping, AU - Wang,Xu-Can, AU - Huang,Ming-Hong, PY - 2017/07/20/received PY - 2018/3/15/entrez PY - 2018/3/15/pubmed PY - 2018/8/18/medline KW - Anterior cruciate ligament KW - Collateral ligament KW - Posterior cruciate ligament KW - Segond fracture KW - Static stability structure SP - 155 EP - 159 JF - Zhongguo gu shang = China journal of orthopaedics and traumatology JO - Zhongguo Gu Shang VL - 31 IS - 2 N2 - OBJECTIVE: To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries. METHODS: From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old. Among them, there were 20 cases of anterior cruciate ligament rupture (ACL rupture) involving the anterior cruciate ligament tibial eminence avulsion fracture included, 3 cases of posterior cruciate ligament rupture (PCL rupture), 1 case of ACL rupture combined with PCL rupture, 3 cases of medial collateral ligament tear, and 2 cases combined fractures of tibial plateau (1 case of the medial platform fractures and 1 cases of lateral fracture). All the patients were confirmed by X-rays, CT and MRI. The procedures were performed at 5 to 14 days after the injury(means 7 days). Lysholm scores were used to assess the knee function before and after the operation. RESULTS: The operation time was 40 to 125 minutes (means 85 minutes), the intraoperative blood loss was 10 to 30 ml (means 15 ml). All paients were followed up for 12 to 18 months(means 14 months). The Lysholm scores were significantly improved from preoperative 52.0±4.2 to 91.9±1.4(t=-49.24, P<0.05). The results of drawer test, Lachman test and lateral stress test were negative in all 29 cases, all the fractures of 29 patients were bony union. CONCLUSIONS: The avulsion fracture of the lateral tibial plateau suggests that there are knee joint static and stable structures(joint ligament, joint capsule, meniscus, et al) and even intra articular fractures. Therefore, besides conventional imaging examinations, arthroscopic exploration was also necessary to avoid misdiagnose and provide comprehensive assessments and treatment. This can create favorable conditions for the knee joint function restore maximum. SN - 1003-0034 UR - https://www.unboundmedicine.com/medline/citation/29536687/[Analysis_of_the_characteristics_and_clinical_diagnosis_and_treatment_of_avulsion_fracture_of_the_lateral_edge_of_tibial_plateau]_ L2 - https://medlineplus.gov/leginjuriesanddisorders.html DB - PRIME DP - Unbound Medicine ER -