Classification and morphology of hyperextension tibial plateau fracture

Yao, Xiang; Hu, Minjie; Liu, Hongyuan; Tang, Jilei; Yuan, Jian; Zhou, Kaihua

doi:10.1007/s00264-022-05499-7

Cited by 9 publications

(11 citation statements)

References 32 publications

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“…Despite no direct reference to hyperextension-bicondylar non-union in the literature, more complex fracture patterns, often secondary to high-energy trauma, are more likely to disrupt blood supply and surrounding tissues, leading to greater rates of non-union (10–20 %) [5] . Interestingly, similar hyperextension injuries have been observed in obese patients involved in low-velocity trauma through anterior crushing [2] .…”

Section: Discussionsupporting

confidence: 63%

“…Hyperextension-bicondylar fractures, as seen in our case, comprise of extensive anteromedial metaphyseal comminution and loss of normal posterior sloping of the plateau [2] . These fractures are often unstable, making accurate anatomical restoration difficult [5] .…”

Section: Discussionmentioning

confidence: 54%

“…HTPFs arise from anterior compression and posterior tension across the plateau, and often result in concomitant ligamentous damage and significant knee joint instability [2] . Based on the direction of force, HTPFs are classified into pure hyperextension, hyperextension-valgus, hyperextension-varus and hyperextension-bicondylar, with the latter recognised as the most common type [2] .…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis is primarily made using X-ray, but CT scanning is essential to accurately delineate injury extent. The “four-column and nine-segment” classification stages hyperextension tibial plateau fractures (HTPFs) into four-levels based on injury mechanism, fracture morphology and additional injuries incurred [2] . Surgeons use this system to evaluate initial injury, plan management and predict prognosis, including the likelihood of associated soft-tissue involvement.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reconstruction of a neglected hyperextension-bicondylar tibial plateau fracture 9 months after original injury and review of the literature. What outcomes can be expected?

Wakefield

Giannoudis

2023

Trauma Case Reports

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction of a neglected hyperextension-bicondylar tibial plateau fracture 9 months after original injury and review of the literature. What outcomes can be expected?

Wakefield

Giannoudis

2023

Trauma Case Reports

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“…Hyperextension bicondylar tibial fracture is a speci c type of tibial plateau fracture with a low incidence of approximately 11% of all tibial plateau fractures [2]. The impact of hyperextension on the knee joint leads to fractures of the anterior rim of the tibia along with signi cant ligament injuries [3].…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis and clinical efficacy of hyperextension bicondylar tibial plateau fractures fixed by medial and lateral dual plates and spinal cage

Huang

et al. 2023

Preprint

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Purpose To elucidate the biomechanical characteristics of fracture defect filled with spinal cage by finite element analysis, and investigate the clinical efficacy of medial and lateral dual plates with spinal cage for the treatment of hyperextension bicondylar tibial plateau fractures. Methods A 10-mm cuneiform defective osteotomy of proximal tibia was created in the finite element model to simulate hyperextension bicondylar tibial plateau fractures. The defect area in the established model was filled with spinal cage (Group A) or allograft bones (Group B) after fracture reduction. The biomechanical properties of both models were tested under axial compression loading and the maximum displacement of the fragments was recorded. Furthermore, a retrospective analysis was conducted on 12 patients with hyperextension bicondylar tibial plateau fractures who were surgically treated at the Lower Limb Surgery Ward of Traumatic Orthopedic Department, Xi’an Honghui Hospital from January 2020 to January 2022. The gender, age, cause of injury, associated injury, the preoperative and postoperative posterior tibial slope angle (pTSA), duration between injury and operation, surgical duration, intraoperative blood loss, complications, time of bone healing, time of weight bearing, Rasmussen radiological criteria and HSS scores were collected and analyzed. Results The finite element model showed that the maximum displacement in Group A was 0.1006 mm and that in Group B was 0.1203 mm, whereas the maximum stress in the two groups were 39.70 MPa and 43.69 MPa respectively. Therefore, implantation of spinal cage into the bone defect area after fracture reduction has obvious biomechanical advantages. We also analyzed 12 patients (9 males and 3 females, aged ranging from 27 to 66 years with mean age of 46.0 ± 12.3 years) with Schatzker type VI fractures. The patients were successfully followed up for an average of 12.50 ± 3.37 months (8 to 18 months). The postoperative pTSA was significantly improved related to the preoperative pTSA (P < 0.001). The average duration between injury and operation was 6.08 ± 2.78 days, the average surgical duration was 131.67 ± 32.71 min, and the average intraoperative blood loss was 320.83 ± 113.73ml. Furthermore, the average time of bone healing was 13.58 ± 2.57 weeks and the average time of weight-bearing was 8.33 ± 2.93 weeks. In addition, 33.33% of postoperative complications was observed in 1 case of superficial wound infection and dehiscence, 1 case of delayed union combined with limited range of motion of the knee joint and 2 cases of deep vein thrombosis. The excellent and good rates of Rasmussen radiological criteria and HSS scores were 83.33% and 91.67% respectively. Conclusion Fracture reduction and fixation by medial and lateral dual plates and spinal cage is an effective method for the treatment of hyperextension bicondylar tibial plateau fractures, and has biomechanical advantages such as favorable bone healing time, weight bearing time, radiographic and clinical functional outcomes.

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Fracture mapping of adult femoral neck fractures with three dimensional computed tomography

Öğümsöğütlü

Kılınçoğlu

2023

International Orthopaedics (SICOT)

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Classification and morphology of hyperextension tibial plateau fracture

Cited by 9 publications

References 32 publications

Reconstruction of a neglected hyperextension-bicondylar tibial plateau fracture 9 months after original injury and review of the literature. What outcomes can be expected?

Reconstruction of a neglected hyperextension-bicondylar tibial plateau fracture 9 months after original injury and review of the literature. What outcomes can be expected?

Finite element analysis and clinical efficacy of hyperextension bicondylar tibial plateau fractures fixed by medial and lateral dual plates and spinal cage

Fracture mapping of adult femoral neck fractures with three dimensional computed tomography

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