临床误诊误治2023，Vol.36Issue(8)：22-25,39,5.DOI:10.3969/j.issn.1002-3429.2023.08.005
SchatzkerⅣ型胫骨平台骨折伴前交叉韧带断裂漏诊分析
Analysis of Missed Diagnosis of Schatzker Type Ⅳ Tibial Plateau Fracture with Anterior Cruciate Ligament Rupture
摘要
Abstract
Objective To investigate the clinical characteristics,causes of missed diagnosis and preventive measures of Schatzker type Ⅳ tibial plateau fracture with anterior cruciate ligament rupture.Methods The clinical data of 13 patients with Schatzker type Ⅳ tibial plateau fracture with anterior cruciate ligament rupture,which had been missed in our hospital from January to December 2022,were retrospectively analyzed.Results All patients were treated in the Emergency Depart-ment after injury.X-ray or CT examination of the knee joint was performed to diagnose Schatzker type Ⅳ tibial plateau frac-ture.All cases underwent open reduction and internal fixation of tibial plateau fracture.After the fracture healed well,she was admitted to hospital for internal fixation and complained of instability of the knee joint.After knee MRI examination combined with medical history,she was diagnosed with anterior cruciate ligament rupture,and the symptoms of three patients were sig-nificantly reduced after conservative treatments.Ten patients underwent anterior cruciate ligament reconstruction,knee flexion(109.40±13.55)° at1 month after surgery,Lysholm knee joint score(83.77±6.80)score,and International Knee Joint Scoring Committee score(80.38±9.51)score.The missed diagnosis lasted11 to17(13.10±1.79)months.Conclusion Schatzker typeⅣtibial plateau fracture with anterior cruciate ligament rupture is more likely to be missed.Special attention should be paid to the soft tissue injury around the knee joint during the clinical examination of patients similar to those de-scribed in this article.MRI of the knee joint should be routinely performed,knee arthroscopy can be assisted during the opera-tion,and physical examination under anesthesia after fracture fixation is completed to reduce or avoid missed diagnosis of ante-rior cruciate ligament rupture.关键词
胫骨骨折/SchatzkerⅣ型/前交叉韧带/断裂/漏诊/前交叉韧带重建/体层摄影术,螺旋计算机/磁共振成像Key words
Tibial fractures/Schatzker type Ⅳ/Anterior cruciate ligament/Fracture/Missed diagnosis/Anterior cruciate ligament reconstruction/Tomography,spiral computed/Magnetic resonance imaging分类
医药卫生引用本文复制引用
张澎,肖毅,谢文鹏..SchatzkerⅣ型胫骨平台骨折伴前交叉韧带断裂漏诊分析[J].临床误诊误治,2023,36(8):22-25,39,5.基金项目
山东省自然科学基金青年项目(ZR2020QH312) （ZR2020QH312）
