Functional Evaluation in High Energy (Schatzker Type V and Type VI) Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation

Khatri, Kavin; Lakhotia, Devendra; Vp, Sharma; Gaurav, Kumar; Sharma, Gaurav; Farooque, Kamran

doi:10.1155/2014/589538

Cited by 11 publications

(22 citation statements)

References 25 publications

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“…In a study by Khatri et al, superficial wound infection was seen in 9.2% patients while deep infection was seen in 4.6% of patients. 24 Barei et al, had reported superficial infection in 5.4% patients and deep wound infections 3.6% patients.…”

Section: Discussionmentioning

confidence: 92%

“…In a study of 65 cases of type V and type VI fractures by Khatri et al, 54 patients (83%) had excellent result. 24 A study by Prasad et al has observed excellent oxford knee score in 40% of their patients treated with dual incision and dual plate. 23 The most dreadful complication associated with the management of tibial plateau fractures is infection.…”

Section: Discussionmentioning

confidence: 98%

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Functional outcome of Schatzker type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates

et al. 2017

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INTRODUCTIONSurgical treatment of high-energy tibial plateau fractures remains a challenge due to problems encountered which include wound complications, infection, varus collapse, knee stiffness, and articular malreductions.1-3 High energy tibial fractures usually affect the younger age group in productive life years and have significant socioeconomic impact due to late recovery time and subsequent requirement of early total knee replacement in some complicated cases. 4 Schatzker classified fractures of tibial plateau radiologically from type I to VI.5 Schatzker type V and VI fractures are high-energy fractures often accompanied by other injuries and complications. The complexity of the fracture pattern and the associated soft tissue disruption of these types of fractures contribute to high rate of failure and unsatisfactory results which follow both operative and non-operative management.6,7Several fixation methods could be used for tibial plateau fractures including unilateral fixation with a single plate, dual-plate, a hybrid external fixator or a less invasive stabilizing system. [8][9][10] There is a considerable debate regarding the best method for treating proximal tibia fractures and there is no clear consensus on which leads ABSTRACT Background: Complex tibial plateau fractures remain a challenge to even the most experienced surgeons. These injuries usually affect the young population in their productive years thereby causing socioeconomic impact. We performed a retrospective study to evaluate the functional outcome of of Schatzker type V and VI managed through open reduction and internal fixation. Methods: 26 patients with Schatzker type V and type VI tibial plateau fractures treated with open reduction and internal fixation using plates were included in the study. Three patients were lost to follow up, 23 patients were evaluated in the final analysis. The preoperative, intraoperative data was noted from the indoor files.The final evaluation was done using Oxford knee score and VAS score. Results: There were nine Schatzker type V fractures and 14 patients with Schatzker type VI fractures. The mean duration of follow-up was 68.32 months ranging from 41 months to 126 months. The mean Oxford knee score was 39.78. Patients with Schatzker type VI had mean OKS of 37.7.The mean MPTA and mean PPTA were 88.75 degrees and 7.35 degrees respectively. Average VAS Score was 2.8 ranging from 1 to 3.9. All patients returned to their preinjury level of activity and employment. There were no patients of deep infection. Conclusions:We conclude that open reduction and internal fixation of high-energy tibial plateau fractures gives excellent to good functional outcome with minimal soft tissue complications. The complications can be minimized with proper patient selection and soft tissue dissection.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Functional outcome of Schatzker type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates

et al. 2017

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“…Compared with CT, AP radiography has a lower detection rate of proximal fibula fracture in associated with tibial plateau fractures. [18][19][20][21] Our findings demonstrated distinct fracture characteristics of these combined high-energy tibial plateau and fibula fractures owing to the use of a combination of the Schatzker's and three-column classification systems.…”

Section: Discussionmentioning

confidence: 94%

“…[13][14][15] As previously reported, tibial plateau fractures develop as a result of varus or valgus forces, axial (compressive) force, or both. [16][17][18] The proximal tibiofibular joint, which includes the lateral collateral ligament, biceps femoris tendon, fibular sesamoid bone ligament, and arcuate ligament, provides a stable articulation between the lateral tibial condyle and the fibular head. Therefore, the displacement of the proximal fibula segment eliminates its support of the lateral tibial plateau and potentially complicates fracture reduction.…”

Section: Discussionmentioning

confidence: 99%

Relative Incidence of Proximal Fibula Fractures with Tibial Plateau Fractures: An Investigation of 354 Cases

Liu

Zhang

et al. 2019

J Knee Surg

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We aimed to investigate the incidence of proximal fibula fractures in patients with tibial plateau fractures and to identify risk factors for such combined injuries. From January 2011 to December 2015, 354 patients with tibial plateau fractures who had been admitted to a level 1 trauma center were retrospectively evaluated by an orthopaedic trauma surgeon and two skeletal radiologists. Anteroposterior plain radiography and computed tomography (CT) were used to characterize the injuries, and the incidence of associated proximal fibula fractures was determined. The tibial plateau fractures were classified according to the Schatzker's and three-column classifications. Associated proximal fibula fractures were simultaneously classified with a new fibula fracture classification system. Finally, we determined whether there were statistically significant associations between the presence of a proximal fibula fracture and different types of tibial plateau fractures, as well as sex and age. Proximal fibula fractures were detected in 192 (54.24%) patients using plain radiography and in 215 (60.73%) patients using CT. Logistic regression analysis indicated an increasing trend in the incidence of fibula fractures detected by the CT-based three-column classification system as follows: “age × sex > three columns > age > single posterior column > lateral column + posterior column > medial column + posterior column > medial column + lateral column > single lateral column > single medial column.” Proximal fibula fracture associated with tibial plateau fracture is a common phenomenon worthy of attention. In women, age increases the likelihood of complex tibial plateau fractures, particularly those involving the posterolateral articular surface and diaphysis, as well as the likelihood of developing proximal fibula fractures. This s Level IV diagnostic study.

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“…Dual plating for complex bicondylar tibial plateau (Schatzker type V and VI) fractures has gained popularity because of its optimal functional outcome and patient compliance. Many studies have supported the use of this technique in complex bicondylar tibial plateau citing excellent functional outcomes and better patient compliance [15,18,19] . But still this modality is in evolving phase to improve patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of closed complex tibial plateau fractures treated using dual plating

Parikh¹,

Patil²,

Kulkarni³

et al. 2020

Int. J. Orthop. Sci.

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Background: The tibial plateau fractures represent 1 to 2% of all fractures and approximately 8% of the fractures in elderly. Schatzker type V and VI tibial plateau fracture include Complex bicondylar injuries. The literature pertaining to functional outcome of closed bicondylar tibial plateau (Schatzker type V and VI) fractures treated using dual plates as internal fixation are scant. Material and Methods: A prospective study was undertaken in a Tertiary Hospital from April 2017 to June 2019, 30 cases of closed proximal tibia classified as Schatzker's type V and VI fractures (bicondylar tibial plateau fractures) were managed surgically. The patients were followed up at 2 nd , 6 th , 12 th and 24 th postoperative weeks. Results: Average oxford score was 38.5 ± 6.19, maximum (73.3%) of the patients had the score more than 40. The proportion of people having high oxford score was statistically significant (χ 2 =33.9, p< 0.0001). Conclusion:We conclude that open reduction and internal fixation using dual plates, is an excellent method of treatment of closed bicondylar tibial plateau (Schatzker type V and type VI) fractures in judiciously selected cases and we recommend the same.

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Functional Evaluation in High Energy (Schatzker Type V and Type VI) Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation

Cited by 11 publications

References 25 publications

Functional outcome of Schatzker type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates

Functional outcome of Schatzker type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates

Relative Incidence of Proximal Fibula Fractures with Tibial Plateau Fractures: An Investigation of 354 Cases

Functional outcome of closed complex tibial plateau fractures treated using dual plating

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