| Schatzker type Ⅱ tibial plateau fracture is common tibial plateau injury in clinical work,which mostly occurs in elderly and middle-aged patients.At the moment of fracture,valgus stress and axial compressive stress will act between tibial plateau and femoral condyle,when the lateral joint pressure and medial joint tension of knee joint increase,which leads to varying degrees of injury of LM and MCL.If the soft tissue injury around the knee is not treated effectively and timely,it is easy to accelerate knee joint degeneration,lead to knee joint dysfunction,knee osteoarthritis and other related complications,and have a great impact on the quality of life of patients.Therefore,effective and timely treatment and diagnosis of these injury associated with Schatzker type Ⅱ tibial plateau fracture will help improve the quality of life of patients after surgery and reduce the impact of complications on knee joint function.Schatzker classification is based on X-ray examination,which is commonly used in clinical work.Knee joint computed tomography can not only provide a better evaluation of bone details such as fracture direction,but also a reliable method to evaluate the location and area of collapse.MRI,as a common detection method of knee joint meniscus,ligament and other soft tissue injury,can accurately reflect the injury of soft tissue around the knee joint.Objective:To explore the relationship between the location of collapse and relative area and the injury of lateral meniscus and medial collateral ligament in Schatzker Ⅱ type tibial plateau fracture.Methods:This study selected 64 patients with tibial plateau fracture Schatzker type II who were admitted to our hospital from January 2018 to December2020.All patients had complete imaging data of knee joint after fracture,including anterior and lateral X-ray of knee joint,CT and knee joint MRI.The CT data of the patients after injury were analyzed.Using the four-quadrant / column classification method of tibial plateau fractures proposed by Professor Zhang Shimin,the tibial plateau was divided into anterolateral(AL),posterolateral(PL),anteromedial(AM)and posteromedial(PM),thus the lateral tibial plateau was divided into two regions: AL and PL.The image processing system was used to determine the location of the collapse center,and according to the location of the collapse center,the patients were divided into AL group(n=33)and PL group(n=31).At the same time,the MRI data of the patients were reviewed to determine whether there was LM and MCL damage.The differences of LM and MCL damage between AL group and PL group were compared,and the relative area of collapse(the ratio of the area of collapse to the area of lateral tibial plateau)was calculated in the image processing system,and the relationship between the relative area of collapse and LM and MCL damage was analyzed.Results:By comparing the damage of LM in two kinds of collapse sites,it was found that the difference was statistically significant(P < 0.05),and the incidence of LM injury in AL area was higher than that in PL area.By comparing the damage of MCL in the two collapse sites,it was found that the difference was statistically significant(P < 0.05).When the collapse location was in the AL area,the incidence of MCL injury was higher than that in the PL area.ROC curve analysis:The area under the LM curve is 0.70,P =0.006;The area under the MCL curve is 0.616,P =0.125;The relative area of lateral platform collapse has statistical significan ce on the damage of LM,but there is no statistical significance on the damage of MCL.Conclusion:When the fracture collapse site of the lateral tibial plateau is in the AL area,the incidence of LM injury is higher than that in the PL area;When the fracture collapse site of the lateral tibial plateau is in the AL area,the incidence of MCL injury is higher than that in the PL area;When the relative area of the lateral plateau collapse is more than 16.62%,attention should be paid to whether it is associated with LM injury. |
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