膝关节韧带损伤与胫骨平台骨折Schatzker及AO分型的相关性分析

目的分析膝关节韧带损伤与胫骨平台骨折Schatzker分型及AO分型的相关性。方法选取2018年1月至2019年6月厦门大学附属福州第二医院骨科收治的28例胫骨平台骨折合并膝关节韧带损伤患者作为研究对象,根据Schatzker分型及AO分型系统对胫骨平台骨折进行分型,同时判定前交叉韧带(anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)、内侧副韧带(medial collateral ligament,MCL)及后外侧角(posterior lateral corner,PLC)的损伤情况,并采用Spearman相关系数分析膝关节韧带损伤与胫骨平台骨折Schatzker分型及AO分型的相关性。结果Schatzker分型与AO分型(仅以关节外、部分关节内和完全关节内3种类型计算)对应分析结果显示,两者具有显著相关性(P=0.000)。Schatzker分型及AO分型与韧带损伤类型Spearman相关分析结果显示,Schatzker分型及AO分型与ACL、MCL及PLC损伤均呈显著相关性(r=-0.465、-0.639、0.756,P=0.013、0.000、0.000;r=-0.588、-0.420、0.532,P=0.001、0.026、0.004),但若AO分型以关节外、部分关节内和完全关节内3种类型计算,则仅与ACL损伤呈显著相关性(r=-0.465,P=0.013)。结论膝关节损伤时膝关节相关韧带之间有一定协同作用,故胫骨平台骨折多合并膝关节韧带损伤,且随着Schatzker分型与AO分型等级的增高,ACL、MCL及PLC损伤的可能性均增大。

Correlation Analysis of Knee Ligament Injuries and Schatzker and AO Classification of Tibial Plateau Fracture

Objective To analyze the correlation between knee ligament injuries and Schatzker and AO classification of tibial plateau fractures.Methods 28 patients with tibial plateau fractures and knee ligament injuries,admitted to Department of Orthopedics,Fuzhou Second Hospital Affiliated to Xiamen University from January 2018 to June 2019,were selected as the study subjects.Their tibial plateau fractures were classified into different types according to Schatzker and AO classification system.At the same time,the damage of anterior cruciate ligament(ACL),posterior cruciate ligament(PCL),medial collateral ligament(MCL)and posterior lateral corner(PLC)were measured.Spearman correlation coefficient was used to analyze the correlation between knee ligament injuries and Schatzker and AO classification of tibial plateau fractures.Results Correlation analysis of Schatzker and AO classification(only three types:extra-articular,partial intraarticular and full intra-articular)showed that there was clear correlation between knee ligament injuries and Schatzker and AO classification of tibial plateau fractures(P=0.000).The Spearman correlation analysis of Schatzker and AO classification and ligament injuries showed that there were significant correlation between Schatzker classification,AO classification and ACL,MCL,PLC injuries(r=-0.465,-0.639,0.756,P=0.013,0.000,0.000;r=-0.588,-0.420,0.532,P=0.001,0.026,0.004).However,if the AO classification is divided into 3 types,namely,extra-articular,partial intra-articular and full intra-articular,it is only significantly correlated with ACL injury(r=-0.465,P=0.013).Conclusion There is a certain synergistic effect between ligaments of knee joint in the case of knee joint injury,so tibial plateau fractures are often combined with knee joint ligament injuries.As the level of Schatzker and AO classification increase,the ACL,MCL and PLC are more prone to be injured.