Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

Prasad, G Thiruvengita; Kumar, T Suresh; Kumar, Rakesh; Murthy, Ganapathy K; Sundaram, Nandkumar

doi:10.4103/0019-5413.108915

Cited by 65 publications

(63 citation statements)

References 29 publications

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“…Three cases had varus deformity less than 10°, and 12 cases had second articular surface depression of less than 5 mm. The average Rasmussen functional score was 27.2 (range, 21-30), whereby 17 cases were excellent (27-30 points) and nine cases were good (20-26 points); the average radiological score was 16.4 (range, [14][15][16][17][18] points, of which all were excellent ( Figs. 1 and 2).…”

Section: Resultsmentioning

confidence: 99%

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Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults

Zhai

Luo

2013

International Orthopaedics (SICOT)

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Purpose This study was to evaluate clinical outcomes and complications following multi-plate reconstruction for treating severe bicondylar tibial plateau fractures of young adults. Methods Between September 2007 and February 2012, 26 patients with severe bicondylar tibial plateau fractures met inclusion criteria; they were treated using multi-plate technique through combined approaches. Patients received an average follow-up of 40.8 (range, 18-64) months, which included anteroposterior and lateral imaging, postoperative complications, range of motion and stability of the knee. The Rasmussen score was applied for functional and radiological evaluation. Results Three to five plates were used for reconstruction. No intra-operative complications occurred. Postoperative complications included bulge of hardware in four patients and superficial dehiscence in three cases in the anterolateral incision of which one developed to deep infection. There was no neurovascular damage, and no implant breakage or loosening. Hardware was removed partly or totally in 16 cases. The average Rasmussen score at final follow-up was 27.2 (range, 21-30) points for functional evaluation and 16.4 (range, 14-18) for radiology. Conclusions Multi-plate reconstruction is a valid and safe method for treating severe bicondylar tibial plateau fractures of young adults.

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Section: Resultsmentioning

confidence: 99%

“…Dual incisions and combined mediallateral plates are the mainstream method for the bicondylar tibial plateau fracture [6,16], also for a large part of so-called complex or high-energy tibial plateau fractures. However, a single locking plate could also solve a high-energy Schatzker type VI fracture and achieve satisfactory outcomes [4,17].…”

Section: Discussionmentioning

confidence: 99%

Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults

Zhai

Luo

2013

International Orthopaedics (SICOT)

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“…22 Prasad et al found that union occurred in 8-22 weeks with a mean of 14 weeks. 23 In our study the Oxford knee score was excellent in 65.21% patients and poor in none. In a study of 65 cases of type V and type VI fractures by Khatri et al, 54 patients (83%) had excellent result.…”

Section: Discussionmentioning

confidence: 79%

“…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. The incidence of infection can be reduced by timing of surgery and proper soft tissue handling.…”

Section: Discussionmentioning

confidence: 99%

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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“…Generally classified as Schatzker type V/VI or AO/OTA 41C are treated with various internal and external fixation techniques. ORIF with dual plating [20] is reported recently in achieving anatomical reduction and stable fixation, but associated with high complication rate. [7] This has led to the usage of different modalities of treatment like Ilizarov and locking plate for fixation.…”

Section: Discussionmentioning

confidence: 99%

Ilizarov and Locking Plate Fixation for Closed Bicondylar Tibial Plateau Fracturesa Prospective Study

Kartheek¹,

Kodandapani²

2017

jemds

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BACKGROUNDIn bicondylar tibial plateau fractures, the most frequently used treatment is ORIF with screws and plates; however, the soft tissue complications are frequently reported. Minimally-invasive Ilizarov technique is an alternative. The purpose of this study was to compare and analyse the clinical and radiological results of locking plate and Ilizarov technique in bicondylar tibial plateau fractures treated at a level I trauma centre. MATERIALS AND METHODSThe patients with closed isolated bicondylar tibial fractures (Schatzker V/VI) were included in the study. Fifteen patients (8 of type V and 7 of type VI) in one group were treated using locked plating system and fifteen patients (5 of type V and 10 of type VI) in another group were treated with Ilizarov technique. Pre-and post-operatively, conventional radiographs, CT scans, hospital stay and complications were evaluated. The outcomes were evaluated using modified Rasmussen clinical and radiological criteria. RESULTSThe two groups were similar demographically. Both the techniques achieved acceptable osseous reduction. When compared with internal fixation, Ilizarov had increased average range of motion (124˚ vs 117˚), decreased complications (p= 0.01), reduced hospital stay (0.001), earlier weight-bearing and marginally faster recovery (outcome in terms of modified Rasmussen clinical assessment score) at 6 months. But the outcomes were not significantly different at 1 year. In this study, Ilizarov technique had slight favourable outcome compared to locked plating group. CONCLUSIONThe Ilizarov method produces a good clinical outcome and is a valuable alternative treatment for bicondylar tibial plateau fractures with added advantage of decreased hospital stay, decreased waiting time for definitive surgery and early weight bearing.

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Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

Cited by 65 publications

References 29 publications

Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults

Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults

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

Ilizarov and Locking Plate Fixation for Closed Bicondylar Tibial Plateau Fracturesa Prospective Study

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