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Miao X, Zhang R, Jiang S, Song Z, Du M, Liu A. Volatile flavor profiles of douchis from different origins and varieties based on GC-IMS and GC-O-QTOF/MS analysis. Food Chem 2024; 460:140717. [PMID: 39121761 DOI: 10.1016/j.foodchem.2024.140717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
The present study comprehensively characterized the flavor differences between different varieties of douchis from different origins using headspace gas chromatography-ion mobility spectrometry (HS-GC-IMS) coupled with gas chromatography-olfactometry-quadrupole time-of-flight mass spectrometry (GC-O-QTOF/MS). A total of 91 volatile organic compounds (VOCs) were identified using HS-GC-IMS and 70 VOCs were identified using GC-O-QTOF/MS, mainly including acids, aldehydes, esters and alcohols. Additionally, 23 key aroma-presenting compounds were screened in five douchi species using relative odor activity value (ROAV) and the aroma compounds that contributed the most to the aroma varied among the five douchi species. Comparative analysis of the GC-IMS and GC-O-QTOF/ MS results yielded 13 VOCs that were detected by both techniques. Nonanal, hexanal, eucalyptol, 1-octen-3-ol, isoamyl acetate, and 2-pentylfuran were identified as key VOCs in the douchi species using both methods. These findings will provide deeper insights for exploring flavor differences in douchi from different geographic sources.
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Affiliation(s)
- Xiaoqing Miao
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Rui Zhang
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Shan Jiang
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Zhiyuan Song
- College of Food Science and Engineering, Dalian Ocean University, Liaoning, Dalian 116034, China
| | - Ming Du
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Aidong Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Mackie DB, Mitchell BC, Siow MY, Onodera KM, Berger GK, Kent WT. Do associated proximal fibula fractures help predict the severity of tibial plateau fractures? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:2959-2963. [PMID: 36917285 PMCID: PMC10504102 DOI: 10.1007/s00590-023-03513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/26/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Proximal fibula fractures are often associated with tibial plateau fractures, but their relationship is poorly characterized. The purpose of this study was to better define the relationship between tibial plateau injury severity and presence of associated soft tissue injuries. METHODS A retrospective review was performed on all operatively treated tibial plateau fractures at a Level 1 trauma center over a 5-year period. Patient demographics, injury radiographs, CT scans, operative reports and follow-up were reviewed. RESULTS Queried tibial plateau fractures from 2014 to 2019 totaled 217 fractures in 215 patients. Fifty-two percent were classified as AO/OTA 41B and 48% were AO/OTA 41C. Thirty-nine percent had an associated proximal fibula fracture. The presence of a proximal fibula fracture had significant correlation with AO/OTA 41C fractures, as compared with AO/OTA 41B fractures (chi-square, p < 0.001). Of the patients with a lateral split depression type tibial plateau fracture, the presence of a proximal fibula fracture was associated with more articular comminution, measured by number of articular fragments (mean = 4.0 vs. 2.9 articular fragments, p = 0.004). There was also a higher rate of meniscal injury in patients with proximal fibula fractures (37% vs. 20%, p = 0.003). CONCLUSIONS There was a significant relationship between the higher energy tibial plateau fracture type (AO/OTA 41C) and the presence of an associated proximal fibula fracture. The presence of a proximal fibula fracture with a tibial plateau fracture is an indicator of a higher energy injury and a higher likelihood of meniscal injury.
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Affiliation(s)
- Duncan B Mackie
- Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Brendon C Mitchell
- Department of Orthopedic Surgery, University of California, 200 West Arbor Drive, San Diego, CA, 92103, USA
| | - Matthew Y Siow
- Department of Orthopedic Surgery, University of California, 200 West Arbor Drive, San Diego, CA, 92103, USA
| | - Keenan M Onodera
- Department of Orthopedic Surgery, University of California, 200 West Arbor Drive, San Diego, CA, 92103, USA
| | - Garrett K Berger
- Department of Orthopedic Surgery, University of California, 200 West Arbor Drive, San Diego, CA, 92103, USA
| | - William T Kent
- Department of Orthopedic Surgery, University of California, 200 West Arbor Drive, San Diego, CA, 92103, USA.
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Wang X, Yang H, Xu C, Xu X, Zhang C, Jing J. Effect of Schatzker type VI tibial plateau fractures combined with a proximal fibular and/or posterolateral joint facet fracture on early postoperative functional recovery. J Orthop Surg Res 2023; 18:412. [PMID: 37287007 DOI: 10.1186/s13018-023-03887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/28/2023] [Indexed: 06/09/2023] Open
Abstract
PURPOSE The objective of this study was to investigate the effect of proximal fibular and/or posterolateral joint facet (PJF) fractures on early functional recovery after Schatzker type VI tibial plateau fractures (TPFs). METHODS Seventy-nine patients with Schatzker type VI TPFs sustained from November 2016 to February 2021 were divided into three groups according to the integrity of the proximal fibula and PJF (groups A, B, and C). Details including demographics, duration of surgery, and complications were recorded. The Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score, Hospital for Special Surgery (HSS) score, lateral knee pain and lateral hamstring tightness were ascertained at the final follow-up. The HSS and WOMAC scores have high reliability in evaluating knee function and osteoarthritis. RESULTS There was a significant difference in the HSS score between groups A and C (P < 0.001) and between groups B and C (P = 0.036). The hospital stay was significantly different between groups A and C (P = 0.038) and between groups B and C (P = 0.013). There was a significant difference in lateral knee pain and lateral hamstring tightness between groups A and C (P < 0.001) and between groups B and C (P < 0.001). CONCLUSION Our study demonstrates that proximal fibular and PJF fractures do not increase the time from injury to surgery, the incidence of complications, or the duration of surgery for Schatzker type VI TPFs. However, fractures of the proximal fibula significantly increase the hospital stay, reduce knee function, and cause lateral knee pain and lateral hamstring tightness. Combined proximal fibular fracture is more decisive than PJF involvement for prognosis.
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Affiliation(s)
- Xuezi Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Hu Yang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Chungui Xu
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Xinzhong Xu
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Chun Zhang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Juehua Jing
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China.
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Krishna A, Arora S, Goyal R, Kumar M, Naik N, Kumar M. Preventable iatrogenic cause of foot-drop in knee injuries with literature review. Chin J Traumatol 2022; 25:224-231. [PMID: 34330596 PMCID: PMC9252936 DOI: 10.1016/j.cjtee.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/03/2020] [Accepted: 06/30/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Common peroneal nerve palsy is quite disabling and every effort should be made to prevent its injury during the treatment. METHODS We retrospectively reviewed the prospectively collected data of 7 cases of tibial plateau fractures in association with proximal fibula fracture from January 2019 to September 2019 who presented to emergency room of our hospital. RESULTS In addition to fibular neck fracture, the first case had type 6 tibial plateau displaced fracture and the second case had displaced acetabular fracture with instability of knee with tibial tuberosity avulsion. common peroneal nerve palsy developed following application of distal tibial skeletal traction in both the cases. Other 6 such cases remained neurologically intact as traction was not applied to them. CONCLUSION Such iatrogenic complication could have been prevented if the injury pattern of "concomitant medial and lateral columns" of the proximal leg is kept in mind by the treating surgeon before applying skeletal traction.
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Affiliation(s)
- Anant Krishna
- Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sumit Arora
- Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India,Corresponding author.
| | - Rakesh Goyal
- Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India
| | - Manish Kumar
- Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India
| | - Nirup Naik
- Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India
| | - Manoj Kumar
- Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India
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Hu Y, Peng A, Wang S, Pan S, Zhang X. Flexion Tibial Plateau Fractures: 3-dimensional CT Simulation-based Subclassification by Injury Pattern. Orthop Surg 2022; 14:543-554. [PMID: 35132782 PMCID: PMC8926999 DOI: 10.1111/os.13190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022] Open
Abstract
Objective To identify different injury patterns of flexion tibial plateau fractures (FTPFs) with 3D CT simulation technology. The association between these hypothesized injury patterns and concomitant injuries was also investigated. Methods The tibial plateau fracture cases of 297 patients consecutively treated at our trauma center from August 2016 to December 2018 were reviewed retrospectively. A total of 108 patients with FTPFs were enrolled. 3D CT simulation technology was used to reconstruct the position of the knee joint at the time of tibial plateau fracture. The 3D segments for the tibia and femur were created separately, the tibial 3D segment was aligned with the articular surface of the femoral condyle, and then the corresponding injury patterns were deduced. The magnitudes of translation and rotation incurred after the segments were repositioned were calculated by Mimics software. The associations between the hypothesized injury patterns and concomitant injuries were compared. Results FTPFs were classified into two groups according to the fracture region: unicondylar FTPFs (type I) and bicondylar FTPFs (type II). According to the injury patterns simulated in this study, these two types of FTPFs were further subclassified into five subgroups. Type I FTPFs were categorized into two subtypes based on the degree of rotation in the coronal plane (varus < 0°; valgus > 0°): pure flexion‐varus fractures (type IA, −10.23° ± 2.11°, 3.7%, 4/108) and pure flexion‐valgus fractures (type IB, 11.54° ± 2.63°, 26.9%, 29/108). Type II FTPFs were divided into three subgroups based on the degree of rotation in the axial plane (internal rotation >10°; flexion‐neutral −10° to 10°; external rotation <−10°): flexion‐neutral fractures (type IIA, 2.01° ± 3.43°, 13.0%, 14/108), flexion‐internal rotation fractures (type IIB, 23.66° ± 6.17°, 35.2%, 38/108) and flexion‐external rotation fractures (type IIC, −16.23° ± 4.27°, 21.3%, 23/108). The incidence of posterolateral quadrant collapse fractures among type IIB fractures was significantly increased relative to that of type IIC fractures (P < 0.001). The incidence of posterolateral quadrant split fractures, anterolateral quadrant fractures and proximal fibular fractures among type IIC fractures was significantly higher than that among type IIB fractures (P < 0.001). The number of these concomitant injuries significantly differed between type IIB and type IIC fractures (P < 0.001). Conclusion 3D CT simulation‐based subclassification according to the pattern of injury can help surgeons better understand FTPFs and select an appropriate treatment strategy.
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Affiliation(s)
- Yaning Hu
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Aqin Peng
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Shuai Wang
- The Chest Hospital of Hebei, Shijiazhuang, China
| | - Shuo Pan
- The First Hospital of Shijiazhang, Shijiazhuang, China
| | - Xiao Zhang
- Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
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Wu LP, Mayr HO, Cai Q, Huan YQ, Zhu XH, Chen YZ, Tang YP, Huang XY. A New Three-Dimensional Classification of Proximal Tibiofibular Fractures: A Multicenter Study. Orthop Surg 2021; 13:2442-2456. [PMID: 34672099 PMCID: PMC8654672 DOI: 10.1111/os.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives To propose an updated definition of proximal tibia and fibula fracture (PTFF) and establish a three‐dimensional (3D) structure‐based classification of PTFF. Methods In total, 1358 adult patients (837 males and 521 females; 43.61 ± 15.13 years, 1364 affected knees) who were diagnosed with PTFF at the departments of orthopaedic surgery of four hospitals from January 2010 to December 2019 were enrolled. The new classification of PTFF, termed Wu classification, included three parts: classification of columns in the horizontal plane, regions in the frontal plane, and segments in the sagittal plane. All PTFFs were classified according to Schatzker, Luo, and Wu classification systems. Additionally, the incidence and characteristics of PTFFs were analyzed. Results The major internal structural fractures of PTFF were tibial plateau fracture (TPF) only (725, 53.15%), TPF and proximal fibular fracture (274, 20.09%), and isolated avulsion fracture of the posterior cruciate ligament (PCL) (189, 13.86%). Approximately a quarter of PTFF cases could not be classified using Schatzker or Luo classifications, but all PTFF cases could be classified using Wu classification. The most frequent PTFFs included all four columns in region IV, segment 2 (235, 17.23%); the posterolateral and posteromedial columns in region II, segment 2 (191, 14.00%); and the lateral and posterolateral columns in region IV, segment 2 (136, 9.97%). Isolated avulsion fracture of the anterior cruciate ligament (ACL) was categorized as three injury types, most of which involved the lateral and medial columns in region II, segment 1 (40/63, 64%). More than 97% of cases of isolated fractures of the PCL involved the posterolateral and posteromedial columns in region II, segment 2. The most frequent combined avulsion fracture of the ACL and PCL included all four columns in region II, segment 2 (18/24, 75%). All of the isolated avulsion fractures of the ACL were located in segment 1, and all those of the PCL in segment 2. The most common type of isolated proximal fibular fracture involved the posterolateral column in region III, segment 2 (23/26, 88%). The most frequent combined TPF and proximal fibular fracture involved all four columns in region IV, segment 2 (107/274, 39.05%). Conclusions All cases of PTFF could be classified by the new 3D Wu classification which should be beneficial for clinical diagnosis, guidance of treatment, statistical analysis, academic communication, and prognosis, and the most frequent PTFF involved all four columns in region IV, segment 2.
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Affiliation(s)
- Li-Ping Wu
- Department of Joint and Trauma Surgery, Jiangmen Central Hospital (Affiliated Jiangmen Hospital of Sun Yat-Sen University), Jiangmen, China
| | - Hermann O Mayr
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Qin Cai
- Department of Orthopaedic Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine (TCM), (Affiliated Jiangmen TCM Hospital of JiNan University), Jiangmen, China
| | - Yuan-Qiao Huan
- Department of Joint and Trauma Surgery, Jiangmen Central Hospital (Affiliated Jiangmen Hospital of Sun Yat-Sen University), Jiangmen, China
| | - Xiao-Hua Zhu
- Department of Orthopaedic Surgery, Zhongshang Xiaolang people's Hospital (Affiliated Xiaolang Hospital of Southern Medical University), Zhongshang, China
| | - Yuan-Zhuang Chen
- Department of Joint and Trauma Surgery, Jiangmen Central Hospital (Affiliated Jiangmen Hospital of Sun Yat-Sen University), Jiangmen, China
| | - Yi-Ping Tang
- School of Foreign Languages, Southern Medical University, Guangzhou, China
| | - Xin-Yu Huang
- Department of Trauma Surgery, Jiangmen people's Hospital, (Affiliated Jiangmen Hospital of Southern Medical University), Jiangmen, China
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Classification and Treatment Strategies of Concomitant Fibular Column Injuries in Tibial Plateau Fractures. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2698642. [PMID: 34532498 PMCID: PMC8440093 DOI: 10.1155/2021/2698642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/10/2021] [Indexed: 12/05/2022]
Abstract
Background About 1/3 of tibial plateau fractures are associated with proximal fibula fractures, but most proximal fibula fractures are often ignored. The aim of this study was to precisely explain the classification and treatment strategies of six injury types of the fibular column associated with tibial plateau fractures. Methods Patients with ipsilateral proximal fibula and tibial plateau fractures treated in our hospital were retrospectively reviewed from Aug 2007 to Mar 2020. Two experienced surgeons and two radiologists divided fibular column injury into 6 injury types according to the AO classification and four-column nine-segment classification. The treatment scheme (surgically treated or conservatively treated) was also recorded. Results In total, 355 proximal fibula fractures were included. Type 2 fibular head fracture was the most common type of injury in 122, and the segregate of superior tibiofibular syndesmosis was the rarest type in 3. In avulsion injury proximal of fibular pattern, the proportion of patients who need surgical intervention is the highest. Conclusions Six injury types in the four-column nine-segment classification covered all types of bony and soft tissue injuries of the fibular column and concisely explained the injury mechanism. The classification is helpful for the precise judgement and decision-making of the concomitant fibular column injuries in tibial plateau fractures.
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Boluda-Mengod J, Guimerà-García V, Olías-López B, Renovell-Ferrer P, Carrera I, Herrera-Pérez M, Pais-Brito JL. A proposal of a new algorithm for decision-making approaches in open reduction and internal fixation of complex tibial plateau fractures - SOTA algorithm (Spanish Orthopaedic Trauma Association). Injury 2021; 52 Suppl 4:S87-S98. [PMID: 34011441 DOI: 10.1016/j.injury.2021.03.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The correct choice of surgical approaches in complex tibial plateau fractures is essential to achieve adequate reduction and fixation. Detailed fracture morphology and direction of columns displacement, that we have named the Main Deformity Direction (MDD), may aid in selecting the optimal surgical strategy. In this article we present a new algorithm based on MDD and column concepts. The aim of this study was to evaluate the outcomes of a group of tibial plateau fractures treated according to this algorithm. The secondary aim was to evaluate the incidence of the different MDD in our multicolumnar subgroup. PATIENTS AND METHODS Excluding isolated lateral one-column fractures, open fractures and patients not treated following this algorithm, 72 patients with tibial plateau fractures surgically treated with open reduction and internal fixation were collected retrospectively, from three trauma centers, from January 2015 to April 2019. Radiological assessment was performed to establish the columns involved and the MDD. Quality and maintenance of reduction and alignment, complications and functional outcomes were assessed. RESULTS Initial fracture analysis was performed in 72 patients (8 one-column, 35 two-column and 29 multicolumnar fractures). In the multicolumnar group, the posteromedial MDD was the most frequent pattern (17 of 29 patients). Four patients were excluded due to loss of follow-up, resulting 68 patients for final outcome analysis (7 one-column, 34 two-column and 27 multicolumnar). The average follow-up was 18 months (range: 6-52). Excellent/good outcomes were obtained in all one-column, 31 of 34 two-column and 25 of 27 multicolumnar fractures. Incomplete reduction was present in three patients. As complications, we had two loss of reduction, one conversion to knee arthroplasty, one nonunion and one deep infection. No patient presented neurological or vascular problems, knee instability or extension deficit. CONCLUSION Satisfactory results have been obtained following the principles of our algorithm. In addition to the anatomical involvement of columns and segments, we believe that identifying the Main Deformity Direction (MDD) provides useful information for decision-making, especially in multicolumnar fractures. The most frequent MDD in our multicolumnar subgroup was the posteromedial MDD, but more than one-third presented a different MDD, requiring different surgical strategies.
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Affiliation(s)
- Juan Boluda-Mengod
- Hospital Universitario Canarias (HUC), Carretera Ofra s/n., 38320, La Laguna, Tenerife, Spain; School of Medicine, Universidad de La Laguna (ULL), Campus de Ofra, s/n, 38071, La Laguna, Tenerife, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - Vicente Guimerà-García
- Hospital Can Misses (HCM), Carrer de Corona s/n., 07800, Ibiza, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - Beatriz Olías-López
- Hospital Universitario Canarias (HUC), Carretera Ofra s/n., 38320, La Laguna, Tenerife, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - Pablo Renovell-Ferrer
- Consorcio Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, 2, 46014, Valencia, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - Ion Carrera
- Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - Mario Herrera-Pérez
- Hospital Universitario Canarias (HUC), Carretera Ofra s/n., 38320, La Laguna, Tenerife, Spain; School of Medicine, Universidad de La Laguna (ULL), Campus de Ofra, s/n, 38071, La Laguna, Tenerife, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
| | - José Luis Pais-Brito
- Hospital Universitario Canarias (HUC), Carretera Ofra s/n., 38320, La Laguna, Tenerife, Spain; School of Medicine, Universidad de La Laguna (ULL), Campus de Ofra, s/n, 38071, La Laguna, Tenerife, Spain; Spanish Orthopaedic Trauma Association - The Orthopaedic Surgery and Traumatology Spanish Society (SOTA-SECOT), Calle Fernández de los Ríos, 108, 28015, Madrid, Spain.
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The degree of fracture displacement does not affect the risk for concomitant proximal fibular fractures in tibial plateau fractures. INTERNATIONAL ORTHOPAEDICS 2021; 45:2963-2971. [PMID: 33825001 DOI: 10.1007/s00264-021-05034-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The proximal fibula plays an important role in the knee joint; however, it has not been given enough attention by surgeons. This study aimed to investigate the risk factors for concomitant proximal fibular fractures in patients with tibial plateau fractures through computed tomography (CT) imaging. MATERIALS AND METHODS From January 2016 to November 2017, patients who underwent percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures at a level 1 trauma centre institute were included in this retrospective study. Full materials of CT imaging were obtained for measurements. Schatzker's and a newly proposed classification system were used for the fracture of the tibial plateau and proximal fibula, respectively. Several clinical and radiological characteristics were recorded, and the impact of those variables on fibular fractures was assessed with univariate and multivariate analyses. RESULTS In total, 174 patients were enrolled in the study with mean age of 45.6±13.1 years. The incidence of combined proximal fibular fracture was 38.3%. Schatzker type VI fracture had the highest rate of fibular fracture (77.4%). High-energy-pattern tibial plateau fractures (p=0.029) and posterolateral joint facet (PJF) involvements (p=0.002) are risk factors for proximal fibular fracture on multivariate analysis. Neither posterolateral column (PLC) involvements nor fracture displacement correlated with proximal fibular fractures. CONCLUSIONS Proximal fibular fractures were commonly seen among patients who sustained tibial plateau fractures. Schatzker type VI fractures had the highest rate of fibular fractures than other fracture types. High-energy fractures and PJF involvements correlated with a higher risk of proximal fibular fractures. A better understanding and awareness of the risk factors for proximal fibular fractures will provide surgeons with comprehensive understanding of tibial plateau fractures.
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Lv H, Zhang Q, Chen W, Song Z, Zheng Z, Zhang Y. Epidemiological Study of Tibial Plateau Fractures Combined with Intercondylar Eminence Fractures. Orthop Surg 2020; 12:561-569. [PMID: 32347009 PMCID: PMC7189054 DOI: 10.1111/os.12658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate the epidemiological characteristics of tibial plateau fractures combined with intercondylar eminence fractures and identify the risk factors. METHODS This retrospective study enrolled patients with tibial plateau fractures who were treated in the third hospital of Hebei Medical University from January 2015 to December 2018; 1020 patients (693 [68%] men and 327 [32%] women) meeting the inclusion and exclusion criteria had a mean age of 45.2 ± 13.8 years. In total, 506 (50%) cases were left injuries, 495 (48%) were right injuries, and 19 (2%) were bilateral injuries. Among them, 458 (44.9%) with a mean age of 47.0 ± 13.9 years had intercondylar eminence fractures, including 324 men and 134 women. A total of 562 (55.1%) patients were identified without intercondylar eminence fractures, including 369 (65.7%) men and 193 (34.3%) women with an average age of 43.8 ± 13.6 years. The distribution characteristics of tibial plateau fractures with intercondylar eminence involved were identified. The potential associations among fractures and various other factors, such as age, gender, occupation, and mechanism of injury, were explored. RESULTS The highest proportion age group of tibial plateau fractures included the ages 35-54 years, with more men than women for both age groups. For males, the highest proportion age group was 35-44 years, and for females, it was 55-64 years (χ 2 = 71.336, P < 0.01). According to Schatzker classification, type IV tibial plateau fractures had the highest risk of intercondylar eminence being involved (70.6%) without significance with type V (69.5%) and VI (68.2%) but with greater significance with types I (11.9%), II (39.2%), and III (9.4%, χ 2 = 280.187, P < 0.01). Multiple analysis showed that simple fractures, including types I, II, and III (OR 0.108, 95% CI: 0.080-0.145), were less likely to involve intercondylar eminence fractures than complex fractures, including types IV, V, and VI. Patients aged >74 years were more likely to have intercondylar eminence fractures compared with other age groups. Retired patients (OR 4.332, 95% CI: 1.147-16.362) were more likely to have fractured intercondylar eminence. CONCLUSION The current study revealed the characteristics of tibial plateau fractures, especially those involving intercondylar eminence fractures, as well as their proportion, distribution, and risk factors, which can be used as reference data for clinical assessment and surgical protocol selection.
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Affiliation(s)
- Hongzhi Lv
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Qi Zhang
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Wei Chen
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Zhaohui Song
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Zhanle Zheng
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Yingze Zhang
- Editorial DepartmentThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
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Huo Y, Xu G, Yin Z, Yu J, Sun X, Li L, Gu G, Sheng L, Sun H. Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures. Medicine (Baltimore) 2020; 99:e19854. [PMID: 32332643 PMCID: PMC7220780 DOI: 10.1097/md.0000000000019854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery.We followed 200 postoperative patients for 1 year. The modified Hospital for Special Knee Surgery score (HSS score) was used to evaluate the functional recovery of the knee. We supposed 4 morphological characteristics in CT images acting as possible risk factors, including the anteroposterior diameters of posterolateral broken bone fragments (fragment-diameter), the damage to the posterolateral cortex of the tibial head (cortex-damage), the combinational fracture of the proximal fibula (fibula-fracture) or fracture of the medial tibial condyle (medial-condyle-fracture). Multivariate regression models were used to analyze the effect of these factors on the HSS score after adjusting the 2 surgical approaches and other confounders.The average HSS score was 85.1 ± 5.8 for all the patients. We treated 155 patients with the anterolateral approach and 45 patients with the posterolateral approach. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were correlated with the HSS scores (P < .05). After adjusting for the above factors, the Schatzker type, age and gender, compared with anterolateral approach, the posterolateral approach could improve the HSS scores by an average of 3.7 points. The fragment-diameter <20 mm and posterolateral approach interacted on the HSS scores. Comparing posterolateral and anterolateral approaches, we found that the HSS scores of patients with fragment-diameter <20 mm increased by 6.1 points (95% CI: 4.1-8.2) in the posterolateral approach, while those with fragment-diameter ≥20 mm did not significantly improve the HSS scores.The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were independent risk factors associated with the follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. The posterolateral approach could significantly improve the HSS score in the studied hospital.
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Affiliation(s)
- Yongfeng Huo
- First People's Hospital of Lianyungang City, Lianyungang
| | - Gang Xu
- First People's Hospital of Lianyungang City, Lianyungang
| | - Zhaoyang Yin
- First People's Hospital of Lianyungang City, Lianyungang
| | - Jian Yu
- First People's Hospital of Lianyungang City, Lianyungang
| | - Xiao Sun
- First People's Hospital of Lianyungang City, Lianyungang
| | - Leiming Li
- First People's Hospital of Lianyungang City, Lianyungang
| | - Guangxue Gu
- First People's Hospital of Lianyungang City, Lianyungang
| | - Luxin Sheng
- First People's Hospital of Lianyungang City, Lianyungang
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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