경골 고평부 골절 시 슬관절 구조물의 동반손상
Injury to Soft Tissue Knee Structures in Patients with Tibia Plateau Fracture
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목적: 급성 경골 고평부 골절은 많은 경우에서 슬관절 구조물의 손상을 동반한다. 이에 저자들은 급성 경골 고평부 골절과 관련된 연부조직 동반손상을 알아보고자 하였다. 대상 및 방법: 2005년 11월부터 2008년 12월까지 본원에서 급성 경골 고평부 골절로 치료받았던 84명의 환자 중 자기 공명영상을 시행하였던 36 슬관절을 대상으로 하였다. 결과: 자기공명영상을 시행한 36명 중 30예(83.3%)에서 동반손상이 관찰되었으며, 외측 반월상 연골 손상이 17예(47.2%)로 가장 많았고, 내측 반월상 연골 손상 13예(36.1%), 전방십자인대 손상 11예(30.6%), 후방십자인대 손상 3예(8.3%), 내측 측부인대 손상 16예(44.4%), 외측 측부인대 손상 12예(33.3%) 였다. 결론: 급성 경골 고평부 골절시에 연부조직손상이 동반될 수 있기 때문에 경미한 경우에도 자기공명영상 등을 통한 동반손상의 확인 및 적절한 치료 방법의 선택이 필요하다.
Abstract
Purpose: We wanted to analyze the incidence of soft tissue injury associated with fractures of the tibial plateau. Materials and Methods: From November 2005 to December 2008, 36 patients with tibial plateau fractures were examined by radiologic studies. The fractures classified according to Schatzker’s classification by using the plain radiographs and computed tomography, and then magnetic resonance imaging was done for assessing the accompanied injuries of the knee structure. Results: For the 36 cases, accompanying lesions were observed in 30 cases (83.3%). Lateral meniscus damage was the most frequently associated damage, and this was observed in 17 cases (47.2%). Medial meniscus damage was found in 13 cases (36.1%). Anterior crucial ligament damage was found in 11 cases (30.6%). Posterior crucial ligament damage was found in 3 cases (8.3%). Medial collateral ligament damage was found in 16 cases (44.4%) and lateral collateral ligament was found in 8 cases (33.3%). Conclusion: Because soft tissue injury frequently accompanies tibial plateau fracture, MRI evaluation and proper management are necessary regardless of the severity of the fractures.
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