Tibial Spine Fractures: A Long-term Follow-up Study of Open Reduction and Internal Fixation
Notice bibliographique
Résumé
OBJECTIVE: To analyze the long-term (5-27 years) functional and radiologic results of surgically treated tibial spine fractures. DESIGN: Retrospective cohort study. SETTING: University hospital. PATIENTS AND METHODS: Forty-four surgically treated consecutive patients with 44 displaced tibial spine fractures were included in this study. All fractures were classified according to a modified Meyers and McKeever classification. There were 24 men and 20 women. The mean age at time of accident was 24 years (range 9-57 years). Sixteen patients had an open physis at the time of trauma. There were 36 patients with isolated fractures and 8 with multiple fractures. All patients were seen for a 1-year follow-up, and 37 patients (84%) were seen for a long-term follow-up visit. Functional results of these 37 patients were graded using the Lysholm, SF-36, and the Western Ontario and McMaster Universities scores. Radiologic results were graded using the Ahlbäck score. RESULTS: At 1-year follow-up, in all 44 patients, the fracture was fully healed. One patient (3%) needed revision of the osteosynthesis due to hardware failure, and in 1 patient (3%), a deep infection (purulent arthritis) developed that was treated by surgical irrigation. The median knee range of motion (ROM) after 1 year was 125 degrees (range 110-140 degrees). The ROM did not change significantly at long term. After a mean follow-up of 16 years (range 5-27 years), the median knee ROM was 130 degrees (range 115-140 degrees). As measured with an objective testing device, no statistically significant difference of anteroposterior stability between the injured and uninjured legs was found, with a mean difference of 1 mm (range -3.9 to 6.9 mm). The Lysholm score showed good to excellent results in 86% of the patients; the Western Ontario and McMaster Universities score showed a mean of 93 (range 40.63-100) points. The mean SF-36 general health score was 77 (24-99). The Ahlbäck score showed a moderate development of secondary osteoarthritis in 2 of the 37 patients (5%). The 16 patients with an open physis at the time of the operation did not develop axial malalignment at long term. CONCLUSIONS: Surgical treatment of tibial spine fractures offers the possibility to regain full stability of the knee joint and good long-term results after open reduction and internal fixation with low infection rates. Knee function is adequately restored in most patients with a minimal risk of developing secondary osteoarthritis.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».