| Objectives: Cruciate ligament and meniscus are the key structures which maintain the stability of the knee joint and are closely related to the anatomy around the knee.Clinical diagnosis found that tibial plateau fractures were often associated with cruciate ligament and meniscus injuries.Fifty tibial plateau fractures were examined using arthroscopy to explore the clinical features of meniscus and cruciate ligament injury.The aim of this study was to reveal the relationship between tibial plateau fractures and these two kinds of soft tissue injuries.Methods: This study was a prospective observational study.From January 2016 to July 2016,all the patients suffered from closed tibial plateau fractures were enrolled in the study.Finally,a total of 50 patients included.There are 37 males,13 females,with an average age of 45.20 ± 13.99(21-72)years.The patients were diagnosed using X-ray examinations and computed tomography(CT),and the surgical procedure was evaluated using Schatzker classification.All patients were treated with homeopathic redactor and minimally invasive surgery.Arthroscopic examination was carried on after internal fixation through regular anterolateral and anteromedial portals.All intra-articular structures should be thoroughly scrutinized and probed as necessary so that no injuries are overlooked.The number of meniscus and cruciate ligament injury were counted and the incidence of each injury was calculated.The relationship between injury and fracture type of tibial plateau was discussed.Results: In this study,a total of 50 tibial plateau fractures were included.According to CT findings,Schatzker classification identified 1 type Ⅰ,21 type Ⅱ,6 type Ⅲ,7 type Ⅳ,8 type Ⅴ,and 7 type Ⅵ fractures.74%(37/50)tibial plateau fractures were combined with meniscal and/or cruciate ligament injuries.There were 32 cases(64%)of meniscus injuries,11 cases(12%)of cruciate ligament injuries,and 6 cases(12%)of combined injuries.According to the severity of injury,there were 21 cases(42%)of meniscus tears;6 cases(12%)of meniscus contusion or partial damage;5 cases(10%)of degenerative changes;5 cases(10%)of cruciate ligament tear;4 cases(8%)of avulsion fractures;4 cases of partial tear.According to the morphology,there were 12 cases(24%)of peripheral tears(anterior horn 4 cases,posterior horn 2 cases,body 6 cases);3 cases(6%)of Bucket-handle tear;4 cases(8%)of radial tear;3 cases(6%)of flap tear and 2 cases(4%)of horizontal tear.The incidence of meniscus injury for each fracture type was 0%,57.1%(12/21),33.3%(2/6),71.4%(5/7),75.0%(6/8),and 28.6%(2/7).There was no significant difference between tthem(χ~2 = 6.07,P = 0.28).The incidence of meniscus tear was significantly higher than partial damage(χ~2 = 11.42,P <0.01).The incidence of ligament injury for each fracture type was 100%(1/1),23.8%(5/21),16.7%(2/6),42.9%(3/7),25.0%(2/8)and 14.3%(1/7).There was no significant difference between them(χ~2 = 4.13,P = 0.57).The incidence of each type of ligament injury was 8%,10% and 8%,respectively.There was no significant difference either(χ~2 = 0.17,P = 1.00).Conclusion: Tibial plateau fractures are often associated with meniscus and cruciate ligament injuries which should be focused.Through arthroscopy,injuries of intra-articular soft tissue could be clearly diagnosed.In this study,the incidence of meniscus tear was significantly higher than partial damage.Peripheral tear was most commonly seen in tibial plateau fractures and often associated depressed fragments.There was no significant difference between the incidences of meniscus or ligament injuries for each fracture type. |
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